Abstract
Sirs: Paraneoplastic encephalomyelitis (PEM) is often associated with small cell lung cancer (SCLC) and positive anti-Hu antibodies (also called ANNA-1 and Type IIa antibodies) in serum and cerebrospinal fluid CSF [3, 4]. Anti-Hu antibodies react with a family of RNA-binding proteins expressed in the nervous system and SCLC. The possible autoimmune pathogenesis of PEM is based on the presence of these antibodies and inflammatory infiltrates in the affected areas of the nervous system. However, different immunosuppressive treatments have been very ineffective in PEM. These poor results have been attributed to the irreversible neuronal damage seen in postmortem studies [4]. We describe a patient with PEM and SCLC who showed a clear improvement of neurological dysfunction after treatment with corticosteroids. A 68-year-old man was admitted to the hospital with a subacute onset of dizziness, constipation and unsteadiness. The physical examination demonstrated severe orthostatic hypotension, downbeat nystagmus, deep /1
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