Paraneoplastic progressive supranuclear palsy syndrome in a patient with B-cell lymphoma.
An important component in the diagnosis of atypical parkinsonian disorders is the exclusion of secondary causes. Paraneoplastic causes of parkinsonism are extremely rare. We describe a case which presented initially as probable progressive supranuclear palsy (PSP) but on follow-up displayed a rapidly progressive course, unexplained fever, peripheral neuropathy and an abnormal CSF. We highlight the difficulties faced in formulating a diagnosis for this unusual case prior to the discovery of an occult B-cell lymphoma, and discuss its relevance in the exclusion criteria for PSP. A paraneoplastic cause should be considered if disease progression is unusually rapid.
Tan
J H
JH
Division of Neurology, Department of Medicine, National University Hospital, Singapore. mdcwse@nus.edu.sg
Goh
B C
BC
Tambyah
P A
PA
Wilder-Smith
E
E
D000368:Aged; D006801:Humans; D016393:Lymphoma, B-Cell / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D020364:Paraneoplastic Polyneuropathy / Q000175:diagnosis* / Q000209:etiology*; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis*