Narcolepsy, REM sleep behavior disorder, and supranuclear gaze palsy associated with Ma1 and Ma2 antibodies and tonsillar carcinoma

Chris Adams, Andrew McKeon, Michael H. Silber, Rajeev Kumar

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

Objective: To describe a patient with diencephalic and mesencephalic presentation of aMa1 and Ma2 antibody-associated paraneoplastic neurological disorder. Design: Case report. Setting: The Colorado Neurological Institute Movement Disorders Center in Englewood, Colorado, and the Mayo Clinic in Rochester, Minnesota. Patient: A 55-year-old man with a paraneoplastic neurological disorder characterized by rapid eye movement sleep behavior disorder, narcolepsy, and a progressive supranuclear palsy-like syndrome in the setting of tonsillar carcinoma. Intervention: Immunotherapy for paraneoplastic neurological disorder, surgery and radiotherapy for cancer, and symptomatic treatment for parkinsonism and sleep disorders. Main Outcome Measures: Polysomnography, multiple sleep latency test, and neurological examination. Results: The cancer was detected at a limited stage and treatable. After oncological therapy and immunotherapy, symptoms stabilized. Treatment with modafinil improved daytime somnolence. Conclusions: Rapid onset and progression of multifocal deficits may be a clue to paraneoplastic etiology. Early treatment of a limited stage cancer (with or without immunotherapy) may possibly slow progression of neurological symptoms. Symptomatic treatment may be beneficial.

Original languageEnglish (US)
Pages (from-to)521-524
Number of pages4
JournalArchives of neurology
Volume68
Issue number4
DOIs
StatePublished - Apr 1 2011

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

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