Polymyoclonus, laryngospasm, and cerebellar ataxia associated with adenocarcinoma and multiple neural cation channel autoantibodies

Arch Neurol. 2009 Oct;66(10):1285-7. doi: 10.1001/archneurol.2009.203.

Abstract

Objective: To describe and provide audiovisual documentation of a syndrome of polymyoclonus, laryngospasm, and cerebellar ataxia associated with adenocarcinoma and multiple neural cation channel autoantibodies.

Design: Case report with video.

Setting: University hospitals. Patient A 69-year-old woman presented with subacute onset of whole-body tremulousness and laryngospasm attributed to gastroesophageal reflux.

Results: Further evaluation revealed polymyoclonus, cerebellar ataxia, and laryngospasm suspicious of an underlying malignant neoplasm. Surface electromyography of multiple limb muscles confirmed the presence of polymyoclonus. The patient was seropositive for P/Q-type voltage-gated calcium channel antibody; subsequently, whole-body fluorine 18 fluorodeoxyglucose positron emission tomography and cervical lymph node biopsy revealed widespread metastatic adenocarcinoma. Follow-up serologic evaluation revealed calcium channel antibodies (P/Q type and N type) and potassium channel antibody.

Conclusions: We highlight the importance of recognizing polymyoclonus. To our knowledge, this is also the first description of a syndrome of polymyoclonus, laryngospasm, and ataxia associated with adenocarcinoma and these cation channel antibodies.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / complications*
  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / pathology
  • Aged
  • Autoantibodies / immunology*
  • Brain Neoplasms / complications*
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / pathology
  • Calcium Channels, P-Type / immunology
  • Calcium Channels, Q-Type / immunology
  • Cerebellar Ataxia / complications*
  • Electromyography
  • Extremities / innervation
  • Extremities / physiology
  • Female
  • Gastroesophageal Reflux / complications
  • Humans
  • Immunization, Passive
  • Ion Channels / immunology*
  • Laryngismus / complications*
  • Muscle, Skeletal / physiology
  • Myoclonus / complications*
  • Positron-Emission Tomography
  • Potassium Channels / immunology
  • Tomography, X-Ray Computed

Substances

  • Autoantibodies
  • Calcium Channels, P-Type
  • Calcium Channels, Q-Type
  • Ion Channels
  • Potassium Channels