Deterioration of anti-Yo-associated paraneoplastic cerebellar degeneration.

OBJECTIVES: Usually, the course of paraneoplastic cerebellar degeneration(PCD) is stable or progresses only slowly. Sudden marked progression after several years, as in the following case, has not been reported.

CASE REPORT: After a 57 year old female had developed diplopia, cerebellar signs, upper-limb weakness, and bilateral stocking-type hypoesthesia, and Yo-antibodies were positive, PCD and sensory polyneuropathy were diagnosed. Upon further diagnostic work-up ovarian cancer FIGO-IIC was detected and treated with ovarectomy, hysterectomy, omentectomy, and chemotherapy. Within the following years she experienced several relapses and developed multifocal metastasis requiring surgery, various chemotherapies, thermocoagulations, and radiotherapy. During the first years, PCD showed only minor progression. After 5 years, however, asymmetric ataxia and dysarthria acutely deteriorated such that she became severely handicapped and dependent on the help of others. Several cycles of immunoglobulines were ineffective and she died at age 64 years in a severely disabled state without recovery of the PCD.

CONCLUSIONS: PCD, which usually progresses only slowly, can acutely deteriorate without recovery.