Paraneoplastic disorders of eye movements
Shirley H Wray1, Josep Dalmau, Athena Chen
1Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. wray@helix.mgh.harvard.edu
Annals of the New York Academy of Sciences
|September 29, 2011
Summary
Paraneoplastic syndromes can cause abnormal eye movements due to antibodies targeting brain antigens. This study links upbeat nystagmus to cerebellar dysfunction and otolithic pathway imbalance in pancreatic cancer patients.
Area of Science:
- Neuroscience
- Oncology
- Ophthalmology
Background:
- Paraneoplastic syndromes can manifest with diverse neurological symptoms, including abnormal eye movements affecting the brainstem and cerebellum.
- Recent research is elucidating the mechanisms behind syndromes like opsoclonus, saccadic abnormalities, and downbeat nystagmus.
Observation:
- A female patient with pancreatic cancer presented with upbeat nystagmus.
- Her condition involved marked retropulsion and head-position-dependent nystagmus, absent when supine and suppressed with convergence.
- The patient tested positive for anti-Hu antibodies and antibodies against a novel neuronal cell surface antigen.
Findings:
- The observed upbeat nystagmus was attributed to cerebellar-induced imbalance in otolithic pathways.
- Antibodies against neuronal surface antigens, including receptors and channels, are implicated in the pathogenesis of paraneoplastic syndromes.
Implications:
- Abnormal eye movements in paraneoplastic syndromes provide critical insights into disease mechanisms.
- These findings support the investigation of therapies targeting neuronal channels for paraneoplastic disorders.
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