Paraneoplastic Cerebellar Degeneration — SCE Neurology MCQ

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ModerateNeuro-oncologyParaneoplastic Cerebellar DegenerationSCE Neurology

A 60-year-old woman presents with subacute cerebellar ataxia, dysarthria, and nystagmus over 6 weeks. CT chest reveals a small cell lung carcinoma. Which antibody is most likely to be associated with this paraneoplastic cerebellar degeneration?

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Correct answer: A — Anti-Hu (ANNA-1) antibody

The best answer is “Anti-Hu (ANNA-1) antibody”. Parkinsonian syndromes are distinguished by tempo, symmetry, eye movements, falls, autonomic and cognitive features; treatment is individualised to motor and neuropsychiatric burden. The alternatives “Anti-NMDA receptor antibody”, “Anti-Yo (PCA-1) antibody”, “Anti-amphiphysin antibody”, “Anti-CASPR2 antibody” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: NICE NG71 Parkinson disease recommendations: https://www.nice.org.uk/guidance/ng71/chapter/Recommendations