A brainstem paraneoplastic syndrome associated with prostate cancer

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 80; no. 8; pp. 934 - 935
• Main Authors: Berger, J R, Bensalem, M, Dalmau, J
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.08.2009; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Antigens; Ataxia; Autoantibodies; Biological and medical sciences; Brain Stem Neoplasms - complications; Brain Stem Neoplasms - pathology; Brain Stem Neoplasms - therapy; Cancer therapies; Disease; Dysphagia; Eye movements; Family medical history; Humans; Immunoglobulins; Immunoglobulins, Intravenous - therapeutic use; Immunohistochemistry; Larynx; Male; Malformations of the nervous system; Medical sciences; Metabolic disorders; Metastasis; Middle Aged; Muscle pain; Neurology; Paraneoplastic Syndromes, Nervous System - complications; Paraneoplastic Syndromes, Nervous System - pathology; Paraneoplastic Syndromes, Nervous System - therapy; Prostate cancer; Prostatic Neoplasms - complications; Prostatic Neoplasms - pathology; Prostatic Neoplasms - therapy; Nervous system diseases; Urinary system disease; Prostate disease; Paraneoplastic syndrome; Malignant tumor; Male genital diseases; Prostate cancer; Cancer
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.2008.153015

Background:Paraneoplastic syndromes are seldom observed with prostate cancer. A rare paraneoplastic brainstem syndrome associated with prostate cancer is described, and the presence of antineuronal antibodies with this syndrome is demonstrated for the first time.Setting:Tertiary referral centre for neurological disorders.Patient:This 59-year-old man developed ophthalmoplegia, dysarthria, dysphagia, pruritus, ataxia, corticobulbar and corticospinal signs in association with prostate cancer. The disorder was unaffected by treatment of the underlying malignancy, but responded initially to high-dose corticosteroid administration and intravenous immunoglobulins.Results:Antibody to intracellular neuronal antigens was demonstrated in both the serum and the cerebrospinal fluid.Conclusions:This unique paraneoplastic syndrome chiefly affecting the brainstem may be a diagnostic clue to the presence of unsuspected prostate adenocarcinoma. Further studies will be required to determine the precise antigenic target.