Myasthenia gravis complicated with cryptococcal meningitis after thymectomy and long-term immunosuppressive therapy.

seen in stroke but with hypometabolism possibly representing a phenomenon of diaschisis. Serial FDG-PET examinations showed markedly increased activity in the basal ganglia as compared with that in the cortex when extrapyramidal features were prominent, which normalised after improvement of this movement disorder. In the setting of paraneoplastic neurological syndrome, FDG-PET imaging can be of value from the following standpoints: [1] detection of the occult malignant focus and [2] objective assessment of the presence and extent of the functional abnormality in the brain and correlation of the imaging findings with the clinical features and disease activity. The literature describing the central nervous system findings with PET in paraneoplastic neurological syndromes are primarily restricted to paraneoplastic limbic encephalitis. FDG-PET usually shows hypermetabolism in one or both temporal lobes, and the magnetic resonance imaging (MRI) findings correlate with the FDG-PET scan results in only a fraction of cases. FDG-PET images can provide additional clinical information which is of great value in further patient management. In conclusions, the FDG-PET more often than the MRI revealed abnormalities in the brainstem, cerebral cortex or cerebellum, some of them clinically silent. FDG-PET might be useful in the evaluation of patients suspected for NMDA receptor encephalitis, but studies to asses the utility for prognosis and treatment planning are necessary.