P-MD020. Ataxia with oculogyric crisis representing early paraneoplastic manifestation

Abstract

Introduction . Paraneoplastic syndrome is an important masquerade involving multisystem disease esp nervous system. Anti-Yo antibody can lead to paraneoplastic cerebellar degeneration. Oculogyric crisis is a neurological emergency. This 45 year old lady presented with insidious onset clumsiness of movement of all limbs for 15 days, altered behaviour 10 days along with abnormal eye movement for 3 days. There was no significant past history or drug history. Her vitals were stable, with normal cardiovascular, gastrointestinal, respiratory, lymphoreticular and gynaecological examination. There were cerebellar signs in nervous system examination along with oculogyric crisis. Her routine tests along with brain MRI scans were normal and she was managed with intravenous steroids. She showed improvement in her sensorium along with eye movements in the due course of time Results . This patient was suspected for paraneoplastic syndrome, the evaluation revealed Anti-Yo positive status. However, her gynaecological workup did not reveal any significant lesion at present and she has been advised for regular screening. Conclusion . Paraneoplastic syndrome can have a protean manifestation. There should be a suspicion of paraneoplastic syndrome even without evidence or anticipation of a malignancy.