Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-29T03:52:42.188Z Has data issue: false hasContentIssue false

Paraneoplastic Cerebellar Degeneration

Published online by Cambridge University Press:  18 September 2015

B. Posner Jerome*
Affiliation:
Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York
*
Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York, USA 10021
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Paraneoplastic cerebellar degeneration is a rare complication of a number of cancers, particularly small cell lung cancer, gynecologic cancers and Hodgkin’s disease. The disorder is clinically characterized by rapid development of pancerebellar dysfunction, which usually does not improve, and pathologically characterized by loss of Purkinje cells with or without inflammatory infiltrates. In some but not all patients, an autoantibody that reacts with the tumor and Purkinje cells can be found in the serum and spinal fluid of patients with paraneoplastic cerebellar degeneration. The presence of the autoantibody suggests, but does not prove, that the disorder has an autoimmune mechanism for its pathogenesis.

Type
Abstract
Copyright
Copyright © Canadian Neurological Sciences Federation 1993

References

REFERENCES

1.Henson, RA, Urich, H.Cancer and the Nervous System. Blackwell Scientific, London, 1982.Google Scholar
2.Hammack, JE, Posner, JB.Paraneoplastic cerebellar degeneration. In: Pliatakis, A, ed. Cerebellar Degenerations-Clinical Neurobiology. Boston: Kluwer Academic Publishers, in press.Google Scholar
3.Croft, PB, Wilkinson, M.The incidence of carcinomatous neuromyopathy in patients with various types of carcinoma. Brain 1965; 88: 427434.CrossRefGoogle ScholarPubMed
4.Sculier, J-P, Feld, R, Evans, WK, et al.Neurological disorders in patients with small cell lung cancer. Cancer 1987; 60: 22752283.3.0.CO;2-3>CrossRefGoogle ScholarPubMed
5.Schmid, AH, Riede, UN.A morphometric study of the cerebellar cortex from patients with carcinoma. Acta Neuropath 1974; 28: 343352.CrossRefGoogle ScholarPubMed
6.Brouwer, B.Beitrag zur Kenntnis der chronischen diffusen Kleinhirnerkrankunger. Mendels Neurologische Zentralblatt 1919; 38: 674682.Google Scholar
7.Brouwer, B., Biemond, A.Les affections parenchymateuses due cervelet et leur signification du point de vue de l’anatomie et al physiologie de cet organe. J Belg Neurol Psychiatrie 1938; 38: 691757.Google Scholar
8.Brain, WR, Daniel, PM, Greenfield, JG.Subacute cortical cerebellar degeneration and its relation to carcinoma. J Neurol Neurosurg Psychiat 1951; 14: 5975.CrossRefGoogle ScholarPubMed
9.Brain, L, Wilkinson, M.Subacute cerebellar degeneration associated with neoplasms. Brain 1965: 465478.CrossRefGoogle Scholar
10.Russell, DS.Encephalomyelitis and carcinomatous neuropathy. In: van Bogaert, L, Radermecker, J, Hozay, J, Lowenthal, A, eds. The Encephalitides. Amsterdam: Elsevier 1961; 131135.Google Scholar
11.Trotter, JL, Hendin, BA, Osterland, CK.Cerebellar degeneration with Hodgkin’s disease. An immunological study. Arch Neurol 1976; 33:660661.CrossRefGoogle Scholar
12.Hammack, J, Kotanides, H, Rosenblum, MK, Posner, JB.Paraneoplastic cerebellar degeneration: II. Clinical and immunologic findings in 21 patients with Hodgkin’s disease. Neurology 1992; 42: 19381943.Google ScholarPubMed
13.Greenlee, JE, Brashear, HR.Antibodies to cerebellar Purkinje cells in patients with paraneoplastic cerebellar degeneration and ovarian carcinoma. Ann Neurol 1983; 14: 609613.CrossRefGoogle ScholarPubMed
14.Jaeckle, KA, Graus, F, Houghton, A, et al.Autoimmune response patients with paraneoplastic cerebellar degeneration to a Purkinje cell cytoplasmic protein antigen. Ann Neurol 1985; 18: 592600.CrossRefGoogle ScholarPubMed
15.Cunningham, J, Graus, F, Anderson, N, et al.Partial characterization of the Purkinje cell antigens in paraneoplastic cerebellar degeneration. Neurology 1986; 36: 11631168.CrossRefGoogle ScholarPubMed
16.Posner, JB, Furneaux, HM.Paraneoplastic syndromes. In: Waksman, BH, ed. Immunologic Mechanisms in Neurologic and Psychiatric Disease. New York: Raven Press 1990; 187220.Google Scholar
17.Hammack, JE, Kimmel, D, O’Neill, BP, et al.Paraneoplastic cerebellar degeneration: a clinical comparison of patients with and without Purkinje cell cytoplasmic antigens. Mayo Clinic Proc 1990; 65: 14231431.CrossRefGoogle Scholar
18.Anderson, NE, Rosenblum, MK, Posner, JB.Paraneoplastic cerebellar degeneration: clinical-immunological correlations. Ann Neurol 1988; 24: 559567.CrossRefGoogle ScholarPubMed
19.Anderson, NE, Posner, JB, Sidtis, JJ, et al.The metabolic anatomy of paraneoplastic cerebellar degenerati on. Ann Neurol 1988; 23: 533540.CrossRefGoogle Scholar
20.Paone, JF, Jeyasingham, K.Remission of cerebellar dysfunction after pneumonectomy for bronchogenic carcinoma. N Engl J Med 1980; 302: 156.CrossRefGoogle ScholarPubMed
21.Cocconi, G, Ceci, G, Juvarra, G, et al.Successful treatment of subacute cerebellar degeneration in ovarian carcinoma with plasmapheresis. Cancer 1985; 56: 23182320.3.0.CO;2-9>CrossRefGoogle ScholarPubMed
22.Greenberg, HS.Paraneoplastic cerebellar degeneration. A clinical and CT study. J Neuro-Oncol 1984; 2: 377382.CrossRefGoogle ScholarPubMed
23.Hetzel, DJStanhope, RO’Neill, BPet al.Gynecologic cancer in patients with subacute cerebellar degeneration predicted by anti-Purkinje cell antibodies and limited in metastatic volume. Mayo Clin Proc 1990; 65: 15581563.CrossRefGoogle ScholarPubMed
24.Dropcho, EJChen, Y-TPosner, JBet al.Cloning of a brain protein identified by autoantibodies from a patient with paraneoplastic cerebellar degeneration. Proc Natl Acad Sci, USA 1987; 84: 45524556.CrossRefGoogle ScholarPubMed
25.Sakai, KMitchell, DJTsukamoto, Tet al.Isolation of a compiementary DNA clone encoding an autoantigen recognized by an anti-neuronal cell antibody from a patient with paraneoplastic cerebellar degeneration. Ann Neurol 1990; 28: 692698.CrossRefGoogle ScholarPubMed
26.Fathallah-Shaykh, HWolf, SWong, Eet al.Cloning of a leucine-zipper protein recognized by the sera of patients with antibody-associated paraneoplastic cerebellar degeneration. Proc Natl Acad Sci, USA 1991; 88: 34513454.CrossRefGoogle ScholarPubMed
27.Chen, Y-T, Rettig, WJ, Yenamandra, AK, et al.Cerebellar degeneration-related (CDR) antigen: a highly conserved neuroectodermal marker mapped to chromosomes X in human mouse. Proc Natl Acad Sci, USA 1990; 87: 30773081.Google Scholar
28.Dropcho, EJ.Expression of the “onconeural” CDR34 gene in human carcinomas. Neurology 1991; 41 (Suppl 1): 238.Google Scholar
29.Furneaux, HMRosenblum, MKDalmau, Jet al.Selective expression of Purkinje cell antigens in tumor tissue from patients with paraneoplastic cerebellar degeneration. N Engl J Med 1990; 322: 18441851.CrossRefGoogle ScholarPubMed
30.Furneaux, HM, Dropcho, EJ, Barbu, D, et al.Characterization of a cDNA encoding a 34 kd Purkinje neuron protein recognized by sera from patients with paraneoplastic cerebellar degeneration. Proc Natl Acad Sci, USA 1989; 86: 28732877.CrossRefGoogle Scholar
31.Siniscalco, M, Oberie, I, Melis, P, et al.Physical and genetic mapping of the CDR gene with particular reference to its position with respect to the FRAXA site. Am J Med Genetics 1991; 38: 357362.CrossRefGoogle Scholar
32.Peterson, K, Kotanides, H, Furneaux, HM, et al.Anti-Yo positive paraneoplastic cerebellar degeneration: a clinical study of 51 patients. Neurology 1991; 41 (Suppl 1): 362.Google Scholar
33.Brashear, RH, Greenlee, JE, Jaeckle, KA, et al.Anticerebellar antibodies in neurologically normal patients with ovarian neoplasms. Neurology 1989; 39: 16051609.CrossRefGoogle ScholarPubMed
34.Furneaux, HM, Reich, L, Posner, JB.Autoantibody synthesis in the central nervous system of patients with paraneoplastic syndromes. Neurology 1990; 40: 10851091.CrossRefGoogle ScholarPubMed