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Ann N Y Acad Sci. 2011 Sep;1233:279-84. doi: 10.1111/j.1749-6632.2011.06113.x.

Paraneoplastic disorders of eye movements.

Author information

  • 1Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. wray@helix.mgh.harvard.edu

Abstract

Paraneoplastic syndromes affecting the brainstem and cerebellum are reported to cause a variety of abnormalities of eye movements. Recent studies have begun to account for the mechanisms underlying several syndromes, characterized by opsoclonus, slow, or dysmetric saccades, as well as downbeat nystagmus. We provide evidence that upbeat nystagmus in a female patient with pancreatic cancer reflected a cerebellar-induced imbalance of otolithic pathways: she showed marked retropulsion, and her nystagmus was dependent on head position, being absent when supine, and suppressed with convergence. In addition to anti-Hu antibodies, we demonstrated antibodies to a novel neuronal cell surface antigen. Taken with other recent studies, our findings suggest that paraneoplastic syndromes arise due to antibodies against surface neuronal antigens, including receptors and channels. Abnormal eye movements in paraneoplastic syndromes offer insights into the pathogenesis of these disorders and the opportunity to test potential therapies, such as new drugs with effects on neuronal channels.

© 2011 New York Academy of Sciences.

PMID:
21951005
[PubMed - indexed for MEDLINE]
PMCID:
PMC3187877
Free PMC Article

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