Abstract
Neurologic symptoms secondary to a paraneoplastic syndrome (PNS) may be the presenting manifestation of a previously undiagnosed cancer. This case highlights the potential complexity of the PNS associated with renal cell carcinoma, confusion and delay of diagnosis due to positive mouse bioassay, latter presentation as encephalitic syndrome, positive outcome associated with initial treatment with total plasma exchange, as well as absence of recurrence of neurologic symptoms after complete surgical removal of tumour.
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