Transient subacute cerebellar ataxia in a patient with Lambert-Eaton myasthenic syndrome after intracranial aneurysm surgery

Nakamura, Masakazu; Yabe, Ichiro; Sato, Kazunori; Nakano, Fumihito; Yaguchi, Hiroaki; Tsuji, Sachiko; Shiraishi, Hirokazu; Yoneda, Makoto; Tanaka, Keiko; Motomura, Masakatsu; Sasaki, Hidenao

Transient subacute cerebellar ataxia in a patient with Lambert-Eaton myasthenic syndrome after intracranial aneurysm surgery

Nakamura, Masakazu; Yabe, Ichiro; Sato, Kazunori et al.

Clinical Neurology and Neurosurgery, 2008, 110(5), 480-483

Permalink : https://hdl.handle.net/2115/33929

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アクセス権	open access
URI	https://hdl.handle.net/2115/33929
タイトル	Transient subacute cerebellar ataxia in a patient with Lambert-Eaton myasthenic syndrome after intracranial aneurysm surgery
著者	Nakamura, Masakazu ; Yabe, Ichiro ; Sato, Kazunori ; Nakano, Fumihito ; Yaguchi, Hiroaki ; Tsuji, Sachiko ; Shiraishi, Hirokazu ; Yoneda, Makoto ; Tanaka, Keiko ; Motomura, Masakatsu ; Sasaki, Hidenao
著者名 Nakamura, Masakazu
e-Rad_Researcher 60372273 著者名 Yabe, Ichiro
著者名 Sato, Kazunori
著者名 Nakano, Fumihito
著者名 Yaguchi, Hiroaki
著者名 Tsuji, Sachiko
著者名 Shiraishi, Hirokazu
著者名 Yoneda, Makoto
著者名 Tanaka, Keiko
著者名 Motomura, Masakatsu
e-Rad_Researcher 80281806 著者名 Sasaki, Hidenao
言語	英語
発行日	2008-05
出版者	Elsevier
収録物名	Clinical Neurology and Neurosurgery
巻(号)	110(5)
ページ	480-483
抄録	Several reports have presented patients with subacute cerebellar ataxia (subacute CA) and Lambert-Eaton myasthenic syndrome (LEMS). Some clinical features of those patients have been described in the previous reports, such as priority of subacute CA to LEMS or a concurrent occurrence of both diseases, a high incidence of malignancy, less efficacy of the treatment for subacute CA compared with that for LEMS. Cerebellar ataxia in some patients with LEMS has been demonstrated to be caused by serum antibodies to P/Q-type voltage-gated calcium channels (VGCCs). Here, we report a 63-year-old woman with subacute CA and LEMS. Cerebellar ataxia appeared 15 months after the incidence of LEMS, and the onset of cerebellar ataxia was thought to be due to serum anti-P/Q-type VGCCs antibodies. The clinical course of this patient was atypical in that 1) LEMS preceded subacute CA which developed after intracranial aneurysm surgery, 2) no malignancy was detected when both diseases coexisted, 3) symptoms of LEMS did not progress with the onset of cerebellar ataxia, and 4) cerebellar ataxia showed a definite improvement in symptoms and by 123I-IMP SPECT imaging after steroid administration. In addition, it is remarkable that LEMS became aggravated in electrophysiological examinations in contrast to subacute CA. We suggest that these atypical features of subacute CA and the changes in LEMS may be associated with a balance between the amount of serum anti-P/Q-type VGCCs antibodies and the susceptibility of the cerebellum and presynaptic nerve terminals to the antibodies. More cases are needed to investigate the mechanisms involved. The subacute CA and LEMS in this patient have remained comparatively silent after the withdrawal of steroid, and we are continuing to observe her condition.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
PISSN	0303-8467
関連情報	PMID 18295972
関連情報	URI http://www.sciencedirect.com/science/journal/03038467
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1016/j.clineuro.2008.01.002