Unusual magnetic resonance imaging and cerebrospinal fluid findings in paraneoplastic cerebellar degeneration: a sequential study

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Abstract
A 51 year old woman was referred with a 1 month history of gait instability, personality and mood changes. Her medical history was remarkable for cigarette smoking (60 cigarettes/day) and depression. The clinical picture rapidly progressed to severe limb and truncal ataxia, dysarthria, and dysphagia that required nutritional support. She complained of double vision, difficulty in opening the eyes, and weight loss. General examination was significant for cachexia. Neurological examination revealed truncal ataxia, tremor affecting arms, head and, trunk, and she was unable to stand without aid. She had an apparently normal mental …