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August 1995

Immunological and Clinical Response to Immunosuppressive Treatment in Paraneoplastic Cerebellar Degeneration

Author Affiliations

From the Department of Neurology, Hannover (Germany) Medical School (Drs Stark, Wurster, Sailer, and Haas), and the Neurological Clinic, Municipal Hospital, Braunschweig, Germany (Dr Patzold). Dr Stark is now affiliated with Städtische Kliniken Offenbach (Germany).

Arch Neurol. 1995;52(8):814-818. doi:10.1001/archneur.1995.00540320098016

Objective:  To report the clinical and immunological response to immunosuppressive treatment with cyclophosphamide in two patients with paraneoplastic cerebellar degeneration.

Design:  Case reports. Clinical and immunological follow-up data were available for 4½ years in the first patient and for 2 years in the second patient.

Setting:  A 1500-bed university hospital and a 1200-bed university teaching hospital.

Intervention:  Cyclophosphamide intermittent treatment.

Main Outcome Measure:  Clinical disability.

Results:  One of the patients, who was treated from an early stage, recovered completely. The other patient showed a partial clinical response. While the two patients were receiving a maintenance regimen with cyclophosphamide, the conditions of both patients remained stable for at least 2 years. In both patients, intrathecal antibody synthesis declined considerably.

Conclusion:  Early induction of immunosuppressive therapy with cyclophosphamide should be tried in treating patients with paraneoplastic cerebellar degeneration.

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