Summary
A 57 year old female patient demonstrated subacute generalized cerebellar symptoms and the investigations which were done exhibited that the clinical picture was due to the remote effect of multiple myeloma. In this case of paraneoplastic cerebellar degeneration, MRI showed cerebellar vermian atrophy when the brain CT scan was negative.
Diagnosis of multiple myeloma was possible only on about the 17th month of the illness when monoclonal gammapathy-IgG in serum of the patient and abnormal plasma cells of 13% in her bone marrow biopsy were exhibited. Bence-Jones proteinuria with kappa light chain was found in the 3.4th year of the illness. Paraneoplastic cerebellar degeneration disabled the patient in 3-4 months and remained as an irreversible process during the 3.4 years in which she was followed until her death. Chemotherapy for multiple myeloma did not affect the cerebellar syndrome.
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References
Brain WR, Daniel PM, Greenfield JG: Subacute cortical cerebellar degeneration and its relation to carcinoma. J Neurol Neurosurg Psychiatry 14: 59–75, 1951
Brain L, Wilkinson M: Subacute cerebellar degeneration associated with neoplasms. Brain 88: 465–478, 1965
Horwich L, Buxton PH, Ryan GM: Cerebellar degeneration with Hodgkin's disease. J Neurol Neurosurg Psychiatry 29: 45–51, 1986
Henson RA, Urich H: Cortical cerebellar degeneration. In cancer and the nervous system: The neurological manifestations of systemic malignant disease. Oxford, UK: 1982, pp 346–357
Currie S, Henson RA, Morgan HG, Poole AJ: The incidence of the non-metastatic neurological syndromes of obscure origin in the reticulosis. Brain 93: 629–640, 1970
Davis LE, Drachman DB: Myeloma neuropathy-successful treatment of two patients and review of cases. Arch Neurol 27: 507–511, 1972
Greenberg HS: Paraneoplastic cerebellar degeneration. J Neuro-Oncology 2: 377–382, 1984
Kyle RA: Multiple myeloma: Review of 869 cases. Mayo Clin Proc 50: 29–40, 1975
Spaar FW: Paraproteinaenemias and multiple myeloma. In: Vinken PJ, Bruyn GW, Klawans HL (Eds) Handbook of Clinical Neurology (Vol 39) New York: Elsevier North Holland, 1980, pp 131–179
Anderson NE, Budde-Steffen C, Wiley RG, Thurman L, Rosenblum MK, Nadeau SE, Posner JB: A variant of the anti-Purkinje cell antibody in a patient with paraneoplastic cerebellar degeneration. Neurology 38: 1018–1026, 1988
Greenlee JE, Brashear HR: Antibodies to cerebellar Purkinje cells in patients with paraneoplastic cerebellar degeneration and ovarian carcinoma. Ann Neurol 14: 609–613, 1983
Cunningham J, Graus F, Anderson N, Posner JB: Partial characterization of the Purkinje cell antigens in paraneoplastic cerebellar degeneration. Neurology 36: 1163–1168, 1986
Rodriguez M, Truh LI, O'Neill BP, Lennon VA: Autoimmune paraneoplastic cerebellar degeneration. Ultrastructural localization of antibody-binding sites in Purkinje cells. Neurology 38: 1380–1386, 1988
Trotter JL, Hendin BA, Osterland CK: Cerebellar degeneration with Hodgkin Disease. An immunological study. Arch Neurol 33: 660–661, 1976
Greenlee JE, Brashear HR, Jaeckle KA, Stroop WG: Anticerebellar antibodies in sera of patients with paraneoplastic cerebellar degeneration: Studies of antibody specificity and response to plasmapheresis. Ann Neurol 20: 139, 1986
Greenlee JE, Lipton HL: Anticerebellar antibodies in serum and cerebrospinal fluid of a patient with oat cell carcinoma of the lung and paraneoplastic cerebellar degeneration. Ann Neurol 19: 82–85, 1986
Bourdette DN, Nilaver G: Cerebellar degeneration associated with anti-Purkinje cell antibodies and benign IgG monoclonal gammapathies (Abstr.). Neurology 37 (Suppl 1): 291, 1987
Borges LF, Busis NA: Intraneuronal accumulation of myeloma proteins. Arch Neurol 42: 690–694, 1985
Kearshley JH, Johnson P, Halmagyi M: Paraneoplastic cerebellar disease; remission with excision of the primary tumor. Arch Neurol 42: 1208–1210, 1985
Jaeckle KA, Graus F, Houghton A, Cordon-Cardo C, Nielsen SL, Posner JB: Autoimmune response of patients with paraneoplastic cerebellar degeneration to a Purkinje cell cytoplasmic protein antigen. Ann Neurol 18: 592–600, 1985
McDonald WI: Cortical cerebellar degeneration with ovarian carcinoma. Neurology 11: 328–334, 1961
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Akpinar, S., Berk, Ö. & Karaca, L. Paraneoplastic cerebellar degeneration associated with multiple myeloma —3.4 years follow up. J Neuro-Oncol 9, 63–68 (1990). https://doi.org/10.1007/BF00167070
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DOI: https://doi.org/10.1007/BF00167070