Table 2.
Cerebellar ataxia‐predominant phenotypes: accompanying cancers, immunological findings, and paraclinical data.
| Pt no. Age/Gender | Neurological syndrome | Symptoms, signs | Cancer, potential immunologic contributors | NIF CBA Profile, CSF | MRI | CSF WCC/ Pro/ OCB/ Co‐existing Ab | Neurophysiology | |
|---|---|---|---|---|---|---|---|---|
| 24. F/81 | Ataxia | Pan‐cerebellar ataxia | Hodgkin lymphoma | H | Brain: leptomeningeal enhancement | N | ‐ | |
| 25. M/57 | Ataxia | Pan‐cerebellar ataxia | Hepatocellular carcinoma | AH | ‐ | N | ‐ | |
| 26. F/74 | Ataxia | Pan‐cerebellar ataxia | Merkel cell carcinoma, pembrolizumab | AH | Brain: normal | N/N/N/Zic4 | ‐ | |
| 27. M/64 | Ataxia | Pan‐cerebellar ataxia | SCLC | AHL | ‐ | N | ‐ | |
| 28. F/74* | Ataxia | Pan‐cerebellar ataxia vertigo, diplopia |
Merkel cell carcinoma; post‐URI |
AHL | Brain: initially normal, marked cerebellar atrophy at follow‐up | 32/71/8 | ‐ | |
| 29. M/65 | Ataxia | Pan‐cerebellar ataxia, diplopia, nausea, vomiting | Merkel cell carcinoma | AHL | Brain: Cerebellum T2 changes | 15/N/P/0 | ‐ | |
| 30. M/64 | Ataxia | Pan‐cerebellar ataxia, vertigo, nausea, vomiting | SCLC, RA history | AHL | Brain: focal FLAIR changes in the left cerebellar hemisphere suggestive of cerebellitis | 29/97/N/ANNA‐3 | ‐ | |
| 31. M/74 | Ataxia | Encephalopathy, vertigo, diplopia, dysarthria, cerebellar ataxia | ‐ | H | Brain: bilateral T2 hyperintensities in cerebellum | 31/93/N/0 | ‐ | |
| 32. F/64 | Spinocerebellar | Cerebellar ataxia, leg paresthesia, ascending weakness | Leiomyosarcoma | AHL | ‐ | N/N/N/GAD65 | EMG: length‐dependent axonal polyneuropathy | |
| 33. M/56 | Spinocerebellar | Cerebellar ataxia, leg paresthesias | SCLC | AHL | Brain: N | 13/128/P | ‐ | |
| 34. F/61* | Bulbospinal | Ptosis, diplopia, altered taste, pseudobulbar palsy, progressive pain, hyperpathia, weakness in arms | ‐ | AHL | Brain: diffuse T2 FLAIR changes hemispheric white matter & pons, and cervical cord (hazy) | 26/88/N | Normal EMG; slow somatosensory‐evoked potentials, localizing to cervical spinal cord. | |
A, alpha‐internexin; Ab, antibody; ANNA‐3, antineuronal nuclear anitbody type‐3; EEG, electroencephalogram; EMG = electromyography; F, female; FLAIR = fluid‐attenuated inversion recovery; GAD65, glutamic acid decarboxylase 65; H, heavy chain; HIV, human immunodeficiency virus; L, light chain; M, male; N, normal; OCBs, oligoclonal bands (CSF‐exclusive); P, positive; Pro, protein; Pt no., patient number; RA, rheumatoid arthritis; SCLC, small cell lung cancer; WCC, white cell count.
*
Patient evaluated in person at Mayo Clinic.