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Departments of Neurology (Drs. Peterson and Posner) and Pathology (Dr. Rosenblum) and the George C. Cotzias Laboratory of Neuro-Oncology (H. Kotanides and Dr. Posner), Memorial Sloan-Kettering Cancer Center, and the Department of Neurology and Neuroscience (Drs. Peterson and Posner), Cornell University Medical College, New York, NY.
We reviewed the clinical findings in 55 patients with cerebellar degeneration associated with the anti-Yo antibody (an anti-Purkinje cell antibody identified in this study by histochemistry and Western blot). The patients were all women, 26 to 85 years old. Fifty-two of them proved to have malignancies, almost exclusively breast or gynecologic cancers and usually confined to the involved organs and local lymph nodes. One woman had adenocarcinoma of the lung, and in three no malignancy has yet been identified. In 34 of 52 patients with cancer, the neurologic syndrome preceded the diagnosis of cancer and in many led to that diagnosis. Patients subacutely developed a pancere-bellar disorder that was substantially disabling in most, with 37 of 48 assessable patients being unable to walk or sit unassisted. Laboratory evaluation revealed lymphocytic pleocytosis in 35 patients, with eventual cerebellar atrophy on imaging studies in seventeen. The disabling neurologic syndrome generally did not respond to treatment, but the cancer was often successfully treated. The presence of the anti-Yo antibody in patients with cerebellar symptoms warrants an aggressive approach to diagnosis and treatment of the underlying cancer, as many are curable at the time neurologic symptoms develop.
Address correspondence and reprint requests to Dr. Jerome B. Posner, Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021. Dr. Peterson's current address is Department of Neurology, University of Minnesota Medical School, Minneapolis, MN.
Supported in part by NIH Grant #NS26064.
Presented in part at the 43rd annual meeting of the American Academy of Neurology, Boston, MA, April 1991
Received January 17, 1992. Accepted for publication in final form March 24, 1992.
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