PARANEOPLASTIC CEREBELLAR DEGENERATION IN A PATIENT WITH CHEMOTHERAPY-RESPONSIVE OVARIAN-CANCER

A 54-year-old female with small volume residual stage III ovarian canc er had received two courses of carboplatin chemotherapy with obvious r esponse, when she developed rapidly progressive neurological symptoms. Over a period of 48 h, an incapacitating syndrome of ataxia, nystagmu s and dysarthria evolved. Central nervous system metastases were exclu ded by computed tomography scanning and cerebrospinal fluid cytology. Anti-Purkinje cell antibodies ('anti-Yo') detected in the serum confir med the diagnosis of paraneoplastic cerebellar degeneration. Isolated reports have suggested that the clinical course of this condition can be ameliorated with high dose steroids and plasmapheresis. However, in this case the very early introduction of both these did not bring abo ut any improvement in the patient's symptoms. She remained severely in capacitated and unable to care for herself for the remaining 15 months of her life. The patient died of progressive ovarian cancer that had become clinically evident 10 months after the onset of neurological sy mptoms. This case illustrates many of the classical features of this r are condition, and the world literature is reviewed.