Abstract
Paraneoplastic neurological syndromes (PNS) are rare disorders associated with various onconeuronal antibodies. Anti-Ri antibodies (ANNA-2) are typically found in patients with opsoclonus myoclonus syndrome (OMS) and ataxia. We present an anti-Ri antibody-positive 77-year-old woman with subacute progressive bilateral cranial nerveVI palsy, gait disturbance and jaw dystonia. MRI of the brain showed hyperintense signals on T2 bitemporal without contrast enhancement. Cerebrospinal fluid (CSF) examination exhibited mild pleocytosis of 13cells/µl and positive oligoclonal bands. CSF was overall inconspicuous for amalignant or inflammatory etiology. Immunofluorescence analysis revealed anti-Ri antibodies in both serum and CSF. Subsequent diagnostic work up resulted in anewly diagnosed ductal carcinoma of the right breast. PNS in this case partially responded to the anti-tumor therapy. This case shows similarities with recently published anti-Ri syndromes, which might form adistinct triad within the anti-Ri spectrum.
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