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December 1982

Truncal Ataxia in Terminal Bronchial Carcinoma

Author Affiliations

Department of Medicine II
Department of Neurosurgery Tan Tock Seng Hospital Singapore 1130

Arch Neurol. 1982;39(12):787-788. doi:10.1001/archneur.1982.00510240049020

To the Editor.—  Truncal ataxia was seen as an interesting clinical feature in a prospective study of the neurologic manifestations in 61 proven cases of bronchial carcinoma. Twelve patients had dysequilibrium; in many, it was an extreme truncal ataxia confining them helplessly to bed during the last two or three months. The dysequilibrium was attributed to a severe neuromyopathy in three patients and to cerebral involvement shown on computed tomographic (CT) scan in nine. Some of the latter patients with cerebral deposits were relieved by a shunt operation, which suggests that truncal ataxia is due to the associated ventricular dilation1 rather than to a lesion of the vermis as is widely thought.2,3Ataxia in carcinoma of lung manifested in two ways. In five patients, the dominant sign was dyssynergia, ie, tremor, dysmetria, and other signs of disturbed coordination resulting in unsteady gait. In 12 others, the salient feature

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