title: Paraneoplastic progressive supranuclear palsy syndrome in a patient with B-cell lymphoma.
abstract: 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.
authors.affiliation: Division of Neurology, Department of Medicine, National University Hospital, Singapore. mdcwse@nus.edu.sg
authors.forename: J H
authors.initials: JH
authors.lastname: Tan
authors.forename: B C
authors.initials: BC
authors.lastname: Goh
authors.forename: P A
authors.initials: PA
authors.lastname: Tambyah
authors.forename: E
authors.initials: E
authors.lastname: Wilder-Smith
mesh_terms: 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*