LEV – No DMT Interaction — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardEpilepsy & Seizure DisordersLEV – No DMT InteractionSCE Neurology

A 52-year-old loses 14 kg after four months of severe diarrhoea, then develops cognitive fluctuation, exaggerated startle, diffuse myoclonus and sleep disturbance. MRI is normal and infection studies are negative. Which antibody would be the most coherent target?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — DPPX antibody

Explanation lettering: B = shown as A · D = shown as B · A = shown as C · C = shown as D

A classically produces limbic encephalitis with prominent seizures and a strong small-cell-lung-cancer association, not prolonged diarrhoea and weight loss. B fits a sleep-led PSP-like syndrome. C fits faciobrachial dystonic seizures and amnesia. D can cause PERM with rigidity, hyperekplexia and myoclonus but does not characteristically explain the gastrointestinal prodrome. E is correct: DPPX autoimmunity combines severe diarrhoea and weight loss with encephalopathy, sleep disturbance, hyperekplexia and myoclonus.

Reference: Autoimmune encephalitis: clinical spectrum and management: https://pn.bmj.com/content/21/5/412