Cerebellar hypermetabolism: an alternative marker for diagnosis of paraneoplastic cerebellar degeneration

Arslan, Doruk; Ardıc, Fadime Sinem; Gultekin-Zaim, Ozge Berna; Tuncel, Murat; Kertmen, Neyran; Göçmen, Rahşan; Yıldız, F.; Tan, Ersin

doi:10.1016/j.nrleng.2022.08.003

Cited by 1 publication

(1 citation statement)

References 8 publications

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“…36 It is estimated that up to 20% of patients with cerebellar ataxia who have an otherwise negative workup may have an autoimmune syndrome and lack a confirmatory diagnostic test, but the characteristic development of subacutely progressive gait ataxia (ie, developing over weeks, reaching a nadir at 6 months, with initially normal MRI but developing midline vermian atrophy) is very typical of all of these syndromes, and initial cerebellar hypermetabolism on PET followed by later hypometabolism has been reported. 11,54 Downbeat nystagmus (especially vibration-induced nystagmus) is a recently described manifestation that appears more often in paraneoplastic cerebellar syndromes compared with nonparaneoplastic syndromes. 11,55 When atrophy is already present on initial imaging, a nonimmune cause is much more likely (eg, toxic, genetic, metabolic) (TABLE 7-6) (CASE 7-3).…”

Section: Iglon5-associated Syndromesmentioning

confidence: 99%

Paraneoplastic Neurologic Syndromes

Graber

2023

CONTINUUM: Lifelong Learning in Neurology

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OBJECTIVE Progress is ongoing in understanding paraneoplastic neurologic disorders, with new syndromes and antibodies being described and more detailed evidence available to guide workup for diagnosis and treatment to improve outcomes. Many excellent reviews have summarized the molecular features of different antibodies, but this article emphasizes the clinical features of each syndrome that may help guide initial diagnosis and treatment, which often should occur before an antibody or cancer is found to confirm the diagnosis. LATEST DEVELOPMENTS Recent findings include updated diagnostic criteria with validated sensitivity and specificity, discovery of novel antibodies, and clinical findings that increase the likelihood of an underlying paraneoplastic disorder. Suggestive syndromes that have been recently identified include faciobrachial dystonic seizures and pilomotor auras in anti–leucine-rich glioma inactivated protein 1 encephalitis, extreme delta brush on EEG in N-methyl-d-aspartate (NMDA)-receptor encephalitis, déjà vu aura in anti–glutamic acid decarboxylase 65 (GAD65) encephalitis, and sleep disturbances in several disorders. In addition, there is confirmed utility of brain positron emission tomography (PET) and CSF markers, including carcinoembryonic antigen and oligoclonal bands, as well as improved tests for the presence of leptomeningeal cancer cells in CSF. Associations of cancer immunotherapies with paraneoplastic syndromes and herpes simplex virus encephalitis (and COVID-19) with NMDA-receptor encephalitis have been described. ESSENTIAL POINTS All neurologists should be aware of advances regarding paraneoplastic neurologic syndromes, as patients can present with a wide variety of neurologic symptoms and earlier diagnosis and treatment can improve outcomes.

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Section: Iglon5-associated Syndromesmentioning

confidence: 99%

Paraneoplastic Neurologic Syndromes

Graber

2023

CONTINUUM: Lifelong Learning in Neurology

View full text Add to dashboard Cite

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Cerebellar hypermetabolism: an alternative marker for diagnosis of paraneoplastic cerebellar degeneration

Cited by 1 publication

References 8 publications

Paraneoplastic Neurologic Syndromes

Paraneoplastic Neurologic Syndromes

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