Abstract
This study aimed to investigate the pathogenesis of a sub-acute progressive asymmetric pancerebellar syndrome in a 54-year-old man with associated mood disturbance, mild cognitive impairment and weight loss. Examination revealed a cachectic man with a reactive, teary and dysthymic affect and mild cognitive impairment. Neurological assessment revealed an asymmetric pancerebellar syndrome with no long-tract signs. An MRI of the brain showed T2-weighted hyperintensity with subtle patchy enhancement in the transverse fibres of the pons, the superior and middle cerebellar peduncles with involvement of the cerebellar white matter. Other investigations including autoimmune, vasculitic and infectious serological screening, and antineuronal antibodies were normal. Paraneoplastic screening was negative. Cererbrospinal fluid (CSF) analysis showed and elevated protein 1.14 g/l, glucose 2.2 and leucocytes
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