PARANEOPLASTIC OPSOCLONUS-MYOCLONUS ASSOCIATED WITH ANTI-HU ANTIBODY

We report a 74-year-old woman with opsoclonus, myoclonus, ataxia, and encephalopathy who had small-cell lung cancer and high titers of anti- Hu antibody in her serum. At autopsy, there were perivascular inflamma tory infiltrates in the brainstem, putamen, and meninges overlying the orbital frontal cortex. Immunohistochemical studies showed the expres sion of the Hu antigens by the tumor and the presence of deposits of a nti-Hu IgG in the patient's cortex, brainstem, and cerebellum, suggest ing that anti-Hu immune response was related to the patient's clinical syndrome. This case of paraneoplastic opsoclonus, myoclonus, ataxia, and encephalopathy expands the spectrum of neurologic dysfunction asso ciated with the anti-Hu antibody.