Paraneoplastic Cerebellar Degeneration Presenting as Subacute Ataxia with Normal Neuroimaging: A Diagnostic Challenge
- 1Department of Neurology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
Abstract
Paraneoplastic cerebellar degeneration (PCD) is a rare immune-mediated neurological syndrome commonly associated with gynecological malignancies and anti-Yo antibodies. Diagnosis is often delayed due to nonspecific presentation and normal imaging. A 48-year-old female presented with progressive imbalance for 2 months and slurred speech for 15 days. Examination revealed cerebellar signs with pyramidal features. Magnetic resonance imaging brain was normal. Cerebrospinal fluid showed mild lymphocytic pleocytosis. Initial treatment with intravenous methylprednisolone resulted in minimal improvement. Further evaluation revealed markedly elevated CA-125 and strongly positive anti-Yo antibodies. Surgical exploration confirmed poorly differentiated squamous cell carcinoma of the ovary. PCD should be suspected in subacute cerebellar ataxia with normal imaging and poor response to steroids. Early tumor detection is critical, although neurological recovery is often limited.
Related
- Multimodal neuroimaging elucidates the posterior-to-anterior gradient of nigrostriatal degeneration in Parkinson’s disease
- Application of Optic Neuritis Diagnostic Criteria in Autoimmune Paraneoplastic CRMP5 Optic Neuropathy and Development of the "CRMP" Score.
- Oculomotor Phenomenology in Cerebellar Ataxias: A Video‐Illustrated Practical Diagnostic Approach
- Cardiometabolic Risk-Driven Diagnosis of Cerebellar Infarction Presenting as Isolated Transient Vertigo: A Case-Based Review.
- Multimodal neuroimaging and electrophysiological signatures in amnestic mild cognitive impairment with different amyloid-β deposition status: correlations with cognitive function and diagnostic value
BibTeX
@article{harsh2026paraneoplastic,
title = {{Paraneoplastic Cerebellar Degeneration Presenting as Subacute Ataxia with Normal Neuroimaging: A Diagnostic Challenge}},
author = {Prateek Harsh and Pravin Umakant Naphade and Prajwal Rao and Satish Nirhale and Shalesh Rohatgi and Srivatsav Addepalli},
journal = {Annals of African Medicine},
year = {2026},
month = jul,
doi = {10.4103/aam.aam_454_26},
url = {https://doi.org/10.4103/aam.aam_454_26},
note = {CC BY-NC-SA 4.0},
}
RIS
TY - JOUR
TI - Paraneoplastic Cerebellar Degeneration Presenting as Subacute Ataxia with Normal Neuroimaging: A Diagnostic Challenge
AU - Prateek Harsh
AU - Pravin Umakant Naphade
AU - Prajwal Rao
AU - Satish Nirhale
AU - Shalesh Rohatgi
AU - Srivatsav Addepalli
PY - 2026
DA - 2026/07/14
JO - Annals of African Medicine
DO - 10.4103/aam.aam_454_26
UR - https://doi.org/10.4103/aam.aam_454_26
AB - Paraneoplastic cerebellar degeneration (PCD) is a rare immune-mediated neurological syndrome commonly associated with gynecological malignancies and anti-Yo antibodies. Diagnosis is often delayed due to nonspecific presentation and normal imaging. A 48-year-old female presented with progressive imbalance for 2 months and slurred speech for 15 days. Examination revealed cerebellar signs with pyramidal features. Magnetic resonance imaging brain was normal. Cerebrospinal fluid showed mild lymphocytic pleocytosis. Initial treatment with intravenous methylprednisolone resulted in minimal improvement. Further evaluation revealed markedly elevated CA-125 and strongly positive anti-Yo antibodies. Surgical exploration confirmed poorly differentiated squamous cell carcinoma of the ovary. PCD should be suspected in subacute cerebellar ataxia with normal imaging and poor response to steroids. Early tumor detection is critical, although neurological recovery is often limited.
SN - 1596-3519
SN - 0975-5764
ER -