IMMUNOLOGICAL AND CLINICAL-RESPONSE TO IMMUNOSUPPRESSIVE TREATMENT IN PARANEOPLASTIC CEREBELLAR DEGENERATION

Objective: To report the clinical and immunological response to immunosuppressive treatment with cyclophosphamide in two patients with paraneoplastic cerebellar degeneration. Design: Case reports. Clinical and immunological follow-up data were available for 4 1/2 years in the first patient and for 2 years in the second patient. Setting: A 1500-bed university hospital and a 1200-bed university teaching hospital. Intervention: Cyclophosphamide intermittent treatment. Main Outcome Measure: Clinical disability. Results: One of the patients, who was treated from an early stage, recovered completely, The other patient showed a partial clinical response. While the two patients were receiving a maintenance regimen with cyclophosphamide, the conditions of both patients remained stable for at least 2 years. In both patients, intrathecal antibody synthesis declined considerably. Conclusion: Early induction of immunosuppressive therapy with cyclophosphamide should be tried in treating patients with paraneoplastic cerebellar degeneration.