Three patients displaying a clinical picture of progressively evolving
multifocal action myoclonus and cerebellar ataxia showed a marked int
rathecal immune activation, which was persistent over a 2- to 5-year t
ime span in the two serially investigated patients. A thorough search
for metabolic, toxic, infectious, or degenerative causes of myoclonus
was unsuccessful. The presence of intrathecal immune activation in at
least a subgroup of patients with the clinical features of progressive
myoclonic ataxia suggests the possibility of immune-mediated damage w
ithin the central nervous system in this condition.