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Paraneoplastic cerebellar degeneration may occur in association with Lambert-Eaton myasthenic syndrome (LEMS), but to our knowledge, the co-occurrence of paraneoplastic opsoclonus-myoclonus syndrome and LEMS has not been previously reported. A 67-year-old woman presented with a complex partial seizure and evolving ocular flutter, opsoclonus, myoclonus and 'cerebellar' signs, all of which improved spontaneously within 6 weeks. Approximately 8 weeks after symptom onset, the patient became encephalopathic, she had a further complex partial seizure, and she became areflexic with potentiation of deep tendon reflexes. Radiological, bronchoscopic and histological investigations revealed small-cell lung cancer, and neurophysiological investigations confirmed a diagnosis of LEMS. High-titre anti-P/Q-type voltage-gated calcium-channel antibodies were identified in the serum, which increased as the signs of opsoclonus and myoclonus resolved. The encephalopathy and clinical features of LEMS responded dramatically to chemotherapy and radiotherapy. Spontaneous improvement of paraneoplastic opsoclonus-myoclonus syndrome may occur, and this syndrome may occur in association with LEMS. Antivoltage-gated calcium-channel antibodies are not implicated in the pathogenesis of paraneoplastic opsoclonus-myoclonus syndrome.

Original publication

DOI

10.1136/jnnp.2009.172684

Type

Journal article

Journal

J Neurol Neurosurg Psychiatry

Publication Date

03/2011

Volume

82

Pages

344 - 346

Keywords

Aged, Antineoplastic Agents, Antineoplastic Agents, Phytogenic, Antineoplastic Combined Chemotherapy Protocols, Carboplatin, Etoposide, Female, Humans, Lambert-Eaton Myasthenic Syndrome, Lung Neoplasms, Opsoclonus-Myoclonus Syndrome, Small Cell Lung Carcinoma