Paraneoplastic optic neuropathy and cerebellar ataxia with small cell carcinoma of the lung

Bilateral optic neuropathy and subacute cerebellar ataxia were manifestatio ns of a paraneoplastic neurologic disorder in a woman found to have small c ell carcinoma of the lung. Serologic tests revealed a neuronal autoantibody specific for CRMP-5, a 62-kd member of the collapsin response-mediating pr otein family. Unexplained optic neuropathy in the setting of subacute cereb ellar ataxia should cause suspicion of a paraneoplastic disorder and prompt testing for this autoantibody, especially in patients at risk for lung car cinoma.