VGCC antibody-positive paraneoplastic cerebellar degeneration presenting with positioning vertigo

Abstract

A 70-year-old woman developed paraneoplastic cerebellar degeneration (PCD) due to P/Q-type and N-type voltage-gated calcium channel antibodies and small cell lung cancer, the main clinical manifestations of which were severe positioning vertigo and vomiting. Loss of the visual suppression of caloric nystagmus, spontaneous downbeat nystagmus, periodic alternating nystagmus, and positioning vertigo in our patient most probably corresponds to the cerebellar flocculus/paraflocculus lesion caused by PCD.

Paraneoplastic vertigo as the presenting symptom of a testicular seminoma

“…Several malignancies, including testicular germ cell tumours,2 3 small cell lung cancer,4 5 adenocarcinoma,4 Hodgkin's lymphoma6 and pancreatic cancer,7 have been associated with paraneoplastic vertigo and nystagmus.…”

Visual Suppression is Impaired in Spinocerebellar Ataxia Type 6 but Preserved in Benign Paroxysmal Positional Vertigo

“…It can appear as a neurologic emergency and mostly the etiology is peripheral [ 1 ]. However, central diseases may mimic peripheral positional vertigo at their initial presentation, e.g., cerebellar (SCA6 [ 2 , 3 ], multiple system atrophy [ 4 ], paraneoplastic cerebellar degeneration [ 5 ], stroke [ 6 ]) as well as brainstem (stroke [ 7 , 8 ], etc .) pathologies.…”

“…Positional vertigo is a common neurologic emergency and mostly the etiology is peripheral [ 1 ]. However, central diseases may mimic peripheral positional vertigo at their initial presentation [ 2 , 3 , 4 , 5 , 6 , 7 , 8 ]. We here describe the results of visual suppression test in six patients with spinocerebellar ataxia type 6 (SCA6), a central positional vertigo [ 2 , 3 ], and nine patients with benign paroxysmal positional vertigo (BPPV), the major peripheral positional vertigo [ 1 ].…”

Subacute Motor Neuron Hyperexcitability with Mercury Poisoning: A Case Series and Literature Review

“…The clinical features of proximal muscle weakness, autonomic symptoms, and reduced tendon reflexes with RNS abnormalities are present in LEMS [23]. Antibodies to VGCC are also detected in a small number of ALS patients and subacute cerebellar ataxias [24,25]. As a result, fasciculation in some ALS patients may be due to the dysfunction of VGCC.…”