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Journal articles on the topic 'Paraneoplastic cerebellar degeneration'

Author: Grafiati

Published: 25 January 2025

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1

Nuzhnyi, E. P., M. Yu Krasnov, A. N. Moskalenko, E. Yu Fedotova, E. O. Chekanova, and S. N. Illarioshkin. "Paraneoplastic cerebellar degeneration." Russian neurological journal 28, no. 4 (October 2, 2023): 43–53. http://dx.doi.org/10.30629/2658-7947-2023-28-4-43-53.

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Introduction. Paraneoplastic cerebellar degeneration (PCD) is an immune-mediated and rapidly progressive cerebellar syndrome that develops as a result of a cross-immune response to the common antigens for the tumor and cerebellar cells. Timely diagnosis and treatment of PCD improves the functional status and survival of these patients.Objective. To analyze the clinical, laboratory and neuroimaging characteristics of PCD case series in comparison with literature data.Material and methods. 16 patients with PCD (13 women, 3 men) were examined. An assessment of the clinical presentation, brain MRI study, blood and cerebrospinal fl uid laboratory tests were carried out, the data of cancer search and patients follow-up were analyzed.Results. The median age of PCD patients was 55 years, the duration of the disease was 8.5 months (range 4 to 16 months). In 12 patients, PCD was the fi rst manifestation of cancer. The clinical prentation was presented by rapidly progressive cerebellar ataxia, often in combination with oculomotor disturbances, pyramidal and bulbar syndrome, hand tremor and dystonia. An associated cancers were detected in 13 patients (81%). Antineuronal antibodies were found in 14 patients (88%): anti-Yo-1, antibodies to amphiphysin, anti-Hu, anti-CV2 and anti-GAD. Mild atrophic changes of the cerebellum were found in 6 patients, and in 2 cases cerebellar hemiatrophy was observed.Conclusion. PCD is a rare disabling but potentially curable disease. The basis of diagnosis is the analysis of the clinical presentation and neuroimaging data, the detection of antineuronal antibodies and in fl ammatory changes in the cerebrospinal fl uid, as well as a thorough cancer search.

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2

Herdlevær, Ida, Mette Haugen, Kibret Mazengia, Cecilie Totland, and Christian Vedeler. "Paraneoplastic Cerebellar Degeneration." Neurology - Neuroimmunology Neuroinflammation 8, no. 2 (February 2, 2021): e963. http://dx.doi.org/10.1212/nxi.0000000000000963.

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ObjectiveInvestigate the value of including cerebellar degeneration-related protein 2-like (CDR2L) as a marker in commercial diagnostic tests for anti-Yo–associated paraneoplastic cerebellar degeneration (PCD).MethodsWe included sera and CSF samples from 24 patients with suspected PCD (6 of whom had PCD with underlying gynecologic or breast cancer), who were positive for Yo antibodies using the commercially available, paraneoplastic neurologic syndromes (PNS) 14 Line Assay from Ravo Diagnostika. The samples were further evaluated using the EUROLINE PNS 12 Ag Line Assay and a cell-based assay (CBA) from Euroimmun. For confirmation of positive lineblot results, we used indirect immunofluorescence of rat cerebellar sections. We also tested all samples in 2 assays developed in-house: a CBA for CDR2L and a Western blot analysis using recombinant cerebellar degeneration-related protein 2 (CDR2) and CDR2L proteins.ResultsIn PNS 14 and PNS 12 Ag Line Assays, anti-CDR2 reactivity was observed for 24 (100%) and 20 (83%) of the 24 samples, respectively. Thirteen of 24 subjects (54%) were also positive using the Euroimmun CBA. Rat cerebellar immunofluorescence was the best confirmatory test. In our in-house CBA for CDR2L and Western blot for CDR2 and CDR2L, only the 6 patients with confirmed PCD reacted with CDR2L.ConclusionsCommercially available tests for Yo antibody detection have low specificity for PCD because these assays use CDR2 as antigen. By adding a test for CDR2L, which is the major Yo antigen, the accuracy of PCD diagnosis greatly improved.Classification of EvidenceThis study provides Class III evidence that a CBA for CDR2L accurately identifies patients with PCD.

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3

Cao, Xia, and Cai-Gang Xu. "Paraneoplastic cerebellar degeneration." Chinese Medical Journal 133, no. 8 (April 2020): 1005–7. http://dx.doi.org/10.1097/cm9.0000000000000736.

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4

Jerome, B. Posner. "Paraneoplastic Cerebellar Degeneration." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 20, S3 (May 1993): S117—S122. http://dx.doi.org/10.1017/s0317167100048629.

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ABSTRACT:Paraneoplastic cerebellar degeneration is a rare complication of a number of cancers, particularly small cell lung cancer, gynecologic cancers and Hodgkin’s disease. The disorder is clinically characterized by rapid development of pancerebellar dysfunction, which usually does not improve, and pathologically characterized by loss of Purkinje cells with or without inflammatory infiltrates. In some but not all patients, an autoantibody that reacts with the tumor and Purkinje cells can be found in the serum and spinal fluid of patients with paraneoplastic cerebellar degeneration. The presence of the autoantibody suggests, but does not prove, that the disorder has an autoimmune mechanism for its pathogenesis.

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5

Bolla, Leela. "Paraneoplastic Cerebellar Degeneration." Archives of Internal Medicine 157, no. 11 (June 9, 1997): 1258. http://dx.doi.org/10.1001/archinte.1997.00440320168016.

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6

Shah, Trusha, Alaina Prince, Vyshak Venur, and Jerome Graber. "NIRL-10 LEPTOMENINGEAL ENHANCEMENT WITH PARANEOPLASTIC CEREBELLAR DEGENERATION: AUTOIMMUNE OR METASTASES?" Neuro-Oncology Advances 6, Supplement_1 (August 2024): i22. http://dx.doi.org/10.1093/noajnl/vdae090.071.

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Abstract Enhancement has been occasionally reported in patients with paraneoplastic cerebellar degeneration but metastases can also occur in these patients and standard imaging and cerebrospinal cytology lack sensitivity and specificity. Among a retrospective case series of 31 patients with paraneoplastic cerebellar degeneration, 4 patients had enhancement at some point of their MRI. We report a series of four patients with paraneoplastic cerebellar degeneration with enhancement and possible concurrent or subsequent leptomeningeal metastases and review the literature. Patient 1 was a 66 year old man with merkel cell carcinoma who had subacute onset of ataxia with nausea. Initial MRI showed non enhancement cerebellar FLAIR changes. Paraneoplastic panel was negative in blood and CSF and seronegative PCD was diagnosed without response to immunosuppression. Eight months later he developed progressive cerebellar symptoms and diffuse leptomeningeal enhancement was found in the cerebellum and spine consistent with leptomeningeal metastates. Patient 2 is a 50 year old woman with HER2+ breast cancer who developed acute cerebellar symptoms with focal cerebellar enhancement and PCA1 antibody was present. Her symptoms stabilized with immune suppression and enhancement resolved, but CSF showed atypical cells suggestive of concurrent leptomeningeal metastases. Patients 3 and 4 both had serous ovarian carcinoma and subacute onset of cerebellar symptoms with cerebellar enhancement and PCA1 antibody with negative CSF cytology. Both stabilized with immune suppression but within months developed more diffuse widespread CNS nodular enhancement considered to be leptomeningeal enhancement. Enhancement is uncommon but not rare in paraneoplastic cerebellar degeneration, occurring in more than 10% of patients in this retrospective series. Others have reported enhancement in paraneoplastic cerebellar degeneration related to autoimmune process alone, but metastases can also occur and may be difficult to distinguish, creating a diagnostic and therapeutic dilemma.

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7

Kim, Sung-Hee. "Paraneoplastic Cerebellar Degeneration Presented as Acute Vertigo." Research in Vestibular Science 21, no. 1 (March 15, 2022): 24–27. http://dx.doi.org/10.21790/rvs.2022.21.1.24.

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Paraneoplastic cerebellar degeneration is a rare neurological manifestation of nonmetastatic malignancy. Its usual manifestation is subacute to chronic dizziness, gait ataxia, and dysarthria. There have been only a few cases of paraneoplastic cerebellar degeneration with acute presentation. This study describes a patient with paraneoplastic cerebellar degeneration, who presented acute vestibular syndrome and then episodically developed horizontal gaze-evoked nystagmus and gait ataxia.

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8

Mizutani, T., S. Maeda, K. Hayakawa, U. Tanaka, S. Hirahata, H. Kamoshita, T. Taketani, and Y. Morimatsu. "Paraneoplastic cortical cerebellar degeneration." Acta Neuropathologica 77, no. 2 (March 1988): 206–12. http://dx.doi.org/10.1007/bf00687433.

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9

Samaha, Shehab, and Andrew J. Larner. "Cerebellar syndrome: cause cured, but symptoms persist." Progress in Neurology and Psychiatry 27, no. 4 (October 2023): 27–29. http://dx.doi.org/10.1002/pnp.812.

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Subacute cerebellar syndromes have a broad differential diagnosis, which includes paraneoplasia. Paraneoplastic cerebellar degeneration needs to be considered in this clinical situation even if initial brain imaging is normal, and the neurological prognosis is guarded even if the underlying tumour can be successfully treated.

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10

Choi, K.-D. "Cerebellar hypermetabolism in paraneoplastic cerebellar degeneration." Journal of Neurology, Neurosurgery & Psychiatry 77, no. 4 (April 1, 2006): 525–28. http://dx.doi.org/10.1136/jnnp.2005.075325.

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11

Gupta, Dr Pushkar, Dr Rajesh Chaudhary, Dr Rizwan Khan, and Punam Jakhar. "Paraneoplastic cerebellar degeneration: A rare paraneoplastic syndrome." International Journal of Applied Research 8, no. 6 (June 1, 2022): 113–14. http://dx.doi.org/10.22271/allresearch.2022.v8.i6b.9831.

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12

Abdulaziz, Ammar Taha Abdullah, Xiao Qing Yu, Le Zhang, Xin Yue Jiang, Dong Zhou, and Jin Mei Li. "Paraneoplastic cerebellar degeneration associated with cerebellar hypermetabolism." Medicine 97, no. 24 (June 2018): e10717. http://dx.doi.org/10.1097/md.0000000000010717.

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13

Baloh, Robert W. "Paraneoplastic Cerebellar Disorders." Otolaryngology–Head and Neck Surgery 112, no. 1 (January 1995): 125–27. http://dx.doi.org/10.1016/s0194-59989570311-x.

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Paraneoplastic cerebellar degeneration typically begins with rapidly progressive ataxia of the trunk and extremities. Antineuronal antibodies are found in about half the patients. The most specific autoantibody is an anti-Purkinje cell antibody found in women with gynecologic tumors. Even after the tumor is removed, the cerebellar deficit persists in most patients.

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14

Loehrer, Philipp Alexander, Lara Zieger, and Ole J. Simon. "Update on Paraneoplastic Cerebellar Degeneration." Brain Sciences 11, no. 11 (October 26, 2021): 1414. http://dx.doi.org/10.3390/brainsci11111414.

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Purpose of review: To provide an update on paraneoplastic cerebellar degeneration (PCD), the involved antibodies and tumors, as well as management strategies. Recent findings: PCD represents the second most common presentation of the recently established class of immune mediated cerebellar ataxias (IMCAs). Although rare in general, PCD is one of the most frequent paraneoplastic presentations and characterized clinically by a rapidly progressive cerebellar syndrome. In recent years, several antibodies have been described in association with the clinical syndrome related to PCD; their clinical significance, however, has yet to be determined. The 2021 updated diagnostic criteria for paraneoplastic neurologic symptoms help to establish the diagnosis of PCD, direct cancer screening, and to evaluate the presence of these newly identified antibodies. Recognition of the clinical syndrome and prompt identification of a specific antibody are essential for early detection of an underlying malignancy and initiation of an appropriate treatment, which represents the best opportunity to modulate the course of the disease. As clinical symptoms can precede tumor diagnosis by years, co-occurrence of specific symptoms and antibodies should prompt continuous surveillance of the patient. Summary: We provide an in-depth overview on PCD, summarize recent findings related to PCD, and highlight the transformed diagnostic approach.

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15

Bonakis, Anastasios, Sokratis G. Papageorgiou, Dimitrios Mandellos, Eleni Galani, and Nikolaos Kalfakis. "Acute onset paraneoplastic cerebellar degeneration." Journal of Neuro-Oncology 84, no. 3 (March 23, 2007): 329–30. http://dx.doi.org/10.1007/s11060-007-9368-5.

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16

Klein, Joshua P., Daniel G. Stover, Geoffrey R. Oxnard, Bruce D. Levy, and Joseph Loscalzo. "Restoring Balance: Paraneoplastic Cerebellar Degeneration." American Journal of Medicine 130, no. 3 (March 2017): e85-e87. http://dx.doi.org/10.1016/j.amjmed.2016.09.035.

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17

Greenlee, John E. "Treatment of Paraneoplastic Cerebellar Degeneration." Current Treatment Options in Neurology 15, no. 2 (January 13, 2013): 185–200. http://dx.doi.org/10.1007/s11940-012-0215-4.

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18

Mudassir, Sanaullah, Ashok Kumar, Neetu Sinha, and Abhay Ranjan. "BREAST CANCER ASSOCIATED ANTI YO-ANTIBODY MEDIATED PARANEOPLASTIC CEREBELLAR DEGENERATION: CASE SERIES AND REVIEW OF LITERATURE." MNJ (Malang Neurology Journal) 8, no. 2 (July 1, 2022): 135–39. http://dx.doi.org/10.21776/ub.mnj.2022.008.02.12.

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Paraneoplastic cerebellar degeneration (PCD) is a rare immune mediated disorder characterized by progressive cerebellar ataxia in presence of onconeural antibodies which occurs due to an indirect effect of underlying malignancy i.e. small cell lung cancer (SCLC), breast and gynecologic cancer, and Hodgkin lymphoma. In about 50% of patients neurological manifestation of Paraneoplastic cerebellar degeneration occurs prior to detection of carcinoma. Anti-Yo Antibody is the commonest antibody present in patients with Paraneoplastic cerebellar degeneration which is associated with breast carcinoma. We describe 3 female patients with anti YO antibody mediated PCD with breast cancer. One patient had a previous diagnosis of breast cancer with post mastectomy status one year back. Two of them presented with ataxia and on further examination, breast lump was found. All three patients had symmetrical ataxia with one patient had severely debilitating ataxia and was not able to walk unassisted. Magnetic resonance imaging brain showed cerebellar atrophy in two patients while one patient had normal MRI. Anti- YO antibody was strongly positive in all the three patients. All patients were given immunotherapy (corticosteroids in 2, Intravenous immunoglobulin in 1) with 1 patient showed modest improvement These case highlights the need to consider for workup for paraneoplastic cerebellar degeneration in female patients presenting with subacute to chronic progressive ataxia, so that the tumors can be detected and treated in early stage with a good outcome.

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19

CARDOSI, R. J., S. L. DECESARE, and W. S. ROBERTS. "Paraneoplastic cerebellar degeneration and gynecologic malignancies." International Journal of Gynecological Cancer 7, no. 4 (July 1997): 279–83. http://dx.doi.org/10.1046/j.1525-1438.1997.00454.x.

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20

LAND, Russell, Jonathan CARTER, Roger HOUGHTON, Ken ATKINSON, and Christopher DALRYMPLE. "Gynaecology meets neurology: Paraneoplastic cerebellar degeneration." Australian and New Zealand Journal of Obstetrics and Gynaecology 45, no. 1 (February 2005): 79–81. http://dx.doi.org/10.1111/j.1479-828x.2005.00330.x.

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21

HENRY, Mr R. J. W., Richard HARRIES-JONES, and V. K. BALAKRISHNAN. "Gynaecology meets neurology: Paraneoplastic cerebellar degeneration." Australian and New Zealand Journal of Obstetrics and Gynaecology 45, no. 4 (August 2005): 342. http://dx.doi.org/10.1111/j.1479-828x.2005.00436.x.

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22

Hadjivassiliou, Marius, Stuart Currie, and Nigel Hoggard. "MR spectroscopy in paraneoplastic cerebellar degeneration." Journal of Neuroradiology 40, no. 4 (October 2013): 310–12. http://dx.doi.org/10.1016/j.neurad.2012.08.003.

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23

Storstein, Anette, Anette Knudsen, and Christian A. Vedeler. "Proteasome antibodies in paraneoplastic cerebellar degeneration." Journal of Neuroimmunology 165, no. 1-2 (August 2005): 172–78. http://dx.doi.org/10.1016/j.jneuroim.2005.04.024.

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24

Simonetti, D., M. Mundo, N. Micillo, G. Piran Arce, N. Mendyk, P. Santoro, A. Gardella, A. Tarulla, P. Elorza, and R. Rotta Escalante. "1-39-08 Paraneoplastic cerebellar degeneration." Journal of the Neurological Sciences 150 (September 1997): S58—S59. http://dx.doi.org/10.1016/s0022-510x(97)85125-8.

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25

McLELLAN, ROBERT, JOHN L. CURRIE, WALTER ROYAL, and NEIL B. ROSENSHEIN. "Ovarian Carcinoma and Paraneoplastic Cerebellar Degeneration." Obstetrics & Gynecology 72, no. 6 (December 1988): 922–25. http://dx.doi.org/10.1097/00006250-198812000-00023.

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26

Shnaider, N. A., V. V. Ezhikova, Yu A. Dykhno, D. V. Dmitrenko, and Yu S. Panina. "Diagnosis problems of paraneoplastic cerebellar degeneration." Neurology, Neuropsychiatry, Psychosomatics, no. 1 (May 6, 2014): 35. http://dx.doi.org/10.14412/2074-2711-2014-1-35-43.

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27

Maeda, K. "Paraneoplastic cerebellar degeneration in olfactory neuroepithelioma." Journal of Neurology, Neurosurgery & Psychiatry 77, no. 1 (January 1, 2006): 123–24. http://dx.doi.org/10.1136/jnnp.2005.066977.

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28

Scheid, R. "Clinical insights into paraneoplastic cerebellar degeneration." Journal of Neurology, Neurosurgery & Psychiatry 77, no. 4 (April 1, 2006): 529–30. http://dx.doi.org/10.1136/jnnp.2005.082206.

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29

Waterhouse, David M., Ronald B. Natale, and Robert L. Cody. "Breast cancer and paraneoplastic cerebellar degeneration." Cancer 68, no. 8 (October 15, 1991): 1835–41. http://dx.doi.org/10.1002/1097-0142(19911015)68:8<1835::aid-cncr2820680833>3.0.co;2-n.

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30

Anderson, Neil E., Marchc K. Rosenblum, and Jerome B. Posner. "Paraneoplastic cerebellar degeneration: Clinical-immunological correlations." Annals of Neurology 24, no. 4 (October 1988): 559–67. http://dx.doi.org/10.1002/ana.410240413.

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31

McLellan, R., JL Currie, W. Royal, and NB Rosenshein. "Ovarian carcinoma and paraneoplastic cerebellar degeneration." International Journal of Gynecology & Obstetrics 29, no. 3 (July 1989): 282. http://dx.doi.org/10.1016/0020-7292(89)90298-1.

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32

Gracien, RM, M. Kordulla, and U. Ziemann. "Paraneoplastic cerebellar degeneration mimicking development of secondary progressive multiple sclerosis in a patient with relapsing–remitting multiple sclerosis." Multiple Sclerosis Journal 17, no. 4 (December 8, 2010): 498–500. http://dx.doi.org/10.1177/1352458510389488.

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Paraneoplastic cerebellar degeneration (PCD) is a rare non-metastatic complication of cancer mediated by T lymphocytes and auto-antibodies directed against Purkinje cells of the cerebellum. We report a patient with relapsing–remitting multiple sclerosis who developed a progressive cerebellar syndrome with dysarthria, ataxic gait and vertigo mimicking development of secondary progressive multiple sclerosis but caused by anti-Yo antibody positive PCD associated with ovarian cancer, presenting an unusual diagnostic challenge.

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33

Sahoo, Debananda, Anupam Dey, Anil Dash, and Arpita Dash. "Ovarian mass Presenting as Paraneoplastic cerebellar degeneration with peripheral neuropathy and anti-Yo antibody." BMJ Case Reports 17, no. 1 (January 2024): e257435. http://dx.doi.org/10.1136/bcr-2023-257435.

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Paraneoplastic neurological syndromes (PNS) are a group of disorders with diverse neurological manifestations that are observed in patients with various types of cancer. Any portion of the nervous system can be affected by these syndromes, which are brought on by processes other than metastasis, direct tumour spread or chemotherapy side effects. An immune-mediated attack on the cerebellar Purkinje cells and consequent cerebellar symptoms define paraneoplastic cerebellar degeneration(PCD), a subtype of the PNS. Axonal or demyelinating paraneoplastic peripheral neuropathies are both possible. Here, we describe the case of a middle-aged woman who presented with subacute-onset cerebellar symptoms and peripheral neuropathy, was discovered to have a positive anti-Yo antibody, and was later detected to have an ovarian mass. This case illustrates the significance of considering a paraneoplastic aetiology in patients with otherwise unexplained neurological manifestations and initiating an appropriate workup and early treatment for the primary malignancy.

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34

Medeiros, Milton César Rodrigues, Milton Takeshi Medeiros, and Damacio Ramon Kaimen Maciel. "Paraneoplastic cerebellar degeneration preceding diagnosis of breast adenocarcinoma." Journal Archives of Health 4, no. 4 (November 28, 2023): 1195–98. http://dx.doi.org/10.46919/archv4n4-010.

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We report a case of a 40 years old patient presenting with paraneoplastic cerebellar degeneration. The diagnosis was made based on the clinical picture of axial and appendicular ataxia, associated with findings on MRI and confirmed by the presence of anti-Yo and anti-Ri antibodies in cerebral spine fluid. From this diagnosis, the search for neoplasm began. An invasive carcinoma was then detected by breast biopsy. Surgical treatment was then carried out with subsequent chemotherapy and radiotherapy. With specific cancer treatment, there was a significant improvement in cerebellar symptoms. The case described shows the importance of the neurologist keeping paraneoplastic syndrome in mind in their differential diagnosis list for cerebellar symptoms and signs of insidious onset.

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35

Suri, Vinit, Nilesh Jadhao, NadeemI Khan, and Rohan Gupta. "Paraneoplastic cerebellar degeneration in Hodgkin′s lymphoma." Annals of Indian Academy of Neurology 15, no. 3 (2012): 205. http://dx.doi.org/10.4103/0972-2327.99720.

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36

Kenney, S. H., P. D. Bromwich, and D. H. Barlow. "Paraneoplastic cerebellar degeneration associated with uterine leiomyomata." Journal of Obstetrics and Gynaecology 10, no. 1 (January 1989): 66. http://dx.doi.org/10.3109/01443618909151107.

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37

Baker, P., A. Mackie, and M. Macpherson. "Paraneoplastic cerebellar degeneration associated with uterine leiomyomata." Journal of Obstetrics and Gynaecology 10, no. 1 (January 1989): 66–67. http://dx.doi.org/10.3109/01443618909151108.

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38

Levite, R., A. Fishman, A. Kesler, M. Altaras, and N. Gadoth. "Paraneoplastic cerebellar degeneration heralding fallopian tube adenocarcinoma." International Journal of Gynecological Cancer 11, no. 2 (March 2001): 169–71. http://dx.doi.org/10.1046/j.1525-1438.2001.00065.x.

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Levite, R., A. Fishman, A. Kesler, M. Altaras, and N. Gadoth. "Paraneoplastic cerebellar degeneration heralding fallopian tube adenocarcinoma." International Journal of Gynecological Cancer 11, no. 2 (March 27, 2001): 169–71. http://dx.doi.org/10.1046/j.1525-1438.2001.011002169.x.

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40

RUSSO, ALESSIA ERIKA, SIMONA SCALONE, GIULIA COSTANZA LEONARDI, AURORA SCALISI, GIORGIO GIORDA, and ROBERTO SORIO. "Paraneoplastic cerebellar degeneration associated with ovarian cancer." Oncology Letters 5, no. 2 (November 7, 2012): 681–83. http://dx.doi.org/10.3892/ol.2012.1016.

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41

Hahn, A., A. Claviez, G. Brinkmann, H. J. Altermatt, R. Schneppenheim, and U. Stephani. "Paraneoplastic Cerebellar Degeneration in Pediatric Hodgkin Disease." Neuropediatrics 31, no. 1 (February 2000): 42–44. http://dx.doi.org/10.1055/s-2000-15297.

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42

Freitas, Diana, Ana Marques, Joana Cunha, Catarina Portela, and Rui Nabiço. "PR95 PARANEOPLASTIC CEREBELLAR DEGENERATION AND BREAST CANCER." Breast 24 (November 2015): S54. http://dx.doi.org/10.1016/s0960-9776(15)30107-7.

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43

Tanaka, Yudai, Nao Suzuki, Masaki Takao, Akiko Ichikawa, Nobuyuki Susumu, and Daisuke Aoki. "Paraneoplastic cerebellar degeneration with fallopian tube adenocarcinoma." Gynecologic Oncology 99, no. 2 (November 2005): 500–503. http://dx.doi.org/10.1016/j.ygyno.2005.06.064.

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44

Bataller, L., E. Fages, and C. Alberola. "Paraneoplastic cerebellar degeneration and anti-Yo antibodies." Neurología (English Edition) 26, no. 5 (2011): e3-e4. http://dx.doi.org/10.1016/s2173-5808(11)70072-4.

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45

Slattery, C. F., M. Agius, and R. Zaman. "Bipolar disorder associated with paraneoplastic cerebellar degeneration." European Psychiatry 23 (April 2008): S224. http://dx.doi.org/10.1016/j.eurpsy.2008.01.398.

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46

Schlake, Hans-Peter, Ingo Wilhelm Husstedt, Karl-Heinz Grotemeyer, and Richard Pötter. "Paraneoplastic subacute cerebellar degeneration in Hodgkin's disease." Clinical Neurology and Neurosurgery 91, no. 4 (January 1989): 329–35. http://dx.doi.org/10.1016/0303-8467(89)90010-3.

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47

Wessel, K., H. C. Diener, G. Schroth, and J. Dichgans. "Paraneoplastic cerebellar degeneration associated with Hodgkin's disease." Journal of Neurology 235, no. 2 (1987): 122–24. http://dx.doi.org/10.1007/bf00718025.

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48

Rico, I. Vazquéz, R. Cabra Rodríguez, B. Rodríguez Bayona, A. Barco Sánchez, M. Á. Castaño López, and A. León-Justel. "Anti-Hu antibody-mediated paraneoplastic cerebellar degeneration." Clinica Chimica Acta 493 (June 2019): S122—S123. http://dx.doi.org/10.1016/j.cca.2019.03.260.

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49

Solà-Valls, Núria, Lydia Gaba, Esteban Muñoz, Begoña Mellado, Teresa Ribalta, Albert Saiz, and Francesc Graus. "Paraneoplastic cerebellar degeneration associated with thymic germinoma." Journal of the Neurological Sciences 320, no. 1-2 (September 2012): 153–55. http://dx.doi.org/10.1016/j.jns.2012.06.021.

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50

Jain, Vanita, Sudesh Prabhakar, Rashmi Bagga, Jaswinder Kalra, and Sarala Gopalan. "Paraneoplastic cerebellar degeneration with ovarian endometroid carcinoma." Acta Obstetricia et Gynecologica Scandinavica 82, no. 7 (July 2003): 672–73. http://dx.doi.org/10.1034/j.1600-0412.2003.00169.x.

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