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

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

Research output: Contribution to journalArticle

36 Citations (Scopus)

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 2011

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REM Sleep Behavior Disorder
Narcolepsy
Paralysis
Carcinoma
Nervous System Diseases
Antibodies
Immunotherapy
Secondary Parkinson Disease
Progressive Supranuclear Palsy
Therapeutics
Neoplasms
Polysomnography
Neurologic Examination
Movement Disorders
Sleep
Radiotherapy
Outcome Assessment (Health Care)
Cancer
Neurological Disorders

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Narcolepsy, REM sleep behavior disorder, and supranuclear gaze palsy associated with Ma1 and Ma2 antibodies and tonsillar carcinoma. / Adams, Chris; McKeon, Andrew B; Silber, Michael H.; Kumar, Rajeev.

In: Archives of Neurology, Vol. 68, No. 4, 04.2011, p. 521-524.

Research output: Contribution to journalArticle

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