Paraneoplastic cerebellar degeneration is a type of paraneoplastic syndrome characterised by the progressive onset of cerebellar dysfunction not explained by tumoral invasion, metastasis, or treatment side effects.
It is an uncommon paraneoplastic syndrome that has been reported in patients with small-cell lung cancer, ovary malignancies, breast carcinoma, and Hodgkin's lymphoma 1.
Cerebellar dysfunction may manifest as dizziness, nausea/vomiting, ataxia, diplopia, dysarthria, or dysphagia 1. A rapidly progressing gait unsteadiness is usually the key symptom that prompt for neuroimaging.
Brain imaging with CT or MRI may show either normal cerebellum, particularly in initial presentation, to eventual diffuse cerebellar atrophy. Cerebellar hemispheric enlargement and cortical-meningeal enhancement have been reported 2.
Treatment and prognosis
The management is focused on the tumour treatment and supportive therapies.
- 1. Afzal S, Recio M, Shamim S. Paraneoplastic cerebellar ataxia and the paraneoplastic syndromes. Proceedings (Baylor University. Medical Center). 28 (2): 217-20. Pubmed
- 2. Dalmau J, Rosenfeld MR. Paraneoplastic syndromes of the CNS. The Lancet. Neurology. 7 (4): 327-40. doi:10.1016/S1474-4422(08)70060-7 - Pubmed