Inpatient rehabilitation performance of patients with paraneoplastic cerebellar degeneration
Jack B Fu1, Vishwa S Raj2, Arash Asher3
1Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.
Objective:
To evaluate the functional improvement of rehabilitation inpatients with paraneoplastic cerebellar degeneration.
Design:
Retrospective review.
Setting:
Referral-based hospitals.
Participants:
Cancer rehabilitation inpatients (N=7) admitted to 3 different cancer centers with a diagnosis of paraneoplastic cerebellar degeneration.
Intervention:
Medical records were retrospectively analyzed for demographic, laboratory, medical, and functional data.
Main Outcome Measure:
FIM.
Results:
All 7 patients were white women (median age, 62y). Primary cancers included ovarian carcinoma (n=2), small cell lung cancer (n=2), uterine carcinoma (n=2), and invasive ductal breast carcinoma (n=1). Mean admission total FIM score was 61±23.97. Mean discharge total FIM score was 73.6±29.35. The mean change in total FIM score was 12.6 (P=.0018). The mean length of rehabilitation stay was 17.1 days. The mean total FIM efficiency was .73. Of the 7 patients, 5 (71%) were discharged home, 1 (14%) was discharged to a nursing home, and 1 (14%) was transferred to the primary acute care service.
Conclusions:
To our knowledge, this is the first study to demonstrate the functional performance of a group of rehabilitation inpatients with paraneoplastic cerebellar degeneration. Despite the poor neurologic prognosis associated with this syndrome, these patients made significant functional improvements in inpatient rehabilitation. When appropriate, inpatient rehabilitation should be considered. Further studies with larger sample sizes are needed.
