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Carbamazepine-Fluconazole Interaction — SCE Neurology MCQ

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HardEpilepsy & Seizure DisordersCarbamazepine-Fluconazole InteractionSCE Neurology

A 61-year-old smoker has subacute amnesia, temporal-lobe seizures and medial temporal T2 hyperintensity. CSF confirms a neuronal-surface antibody. Which antibody–tumour pairing should prompt the most focused initial cancer search?

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

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Correct answer: E — GABA-B-receptor antibody with small-cell lung cancer

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

A is correct: GABA-B-receptor encephalitis is a seizure-dominant limbic encephalitis with a particularly strong association with small-cell lung cancer, making urgent thoracic evaluation central. B is wrong because LGI1 encephalitis is only infrequently paraneoplastic and is not specifically linked to thymoma. C mispairs CASPR2 with ovarian teratoma. D mispairs NMDA-receptor encephalitis, whose classic tumour association is ovarian teratoma. E is not an established IgLON5–Hodgkin pairing.

Reference: Paraneoplastic neurological syndromes: a practical approach: https://pn.bmj.com/content/22/1/19