MOVEMENT DISORDERS IN SYSTEMIC DISEASES: CLASSIC PARANEOPLASTIC SYNDROMES AND CELIAC DISEASE

Abstract

Classical paraneoplastic neurological syndromes (i.e. those associated with antibodies to intracellular antigens) and celiac disease have been associated with a variety of neurological syndromes, including movement disorders. Although both categories have been primarily associated with cerebellar symptoms, a wide range of extrapyramidal clinical pictures has been linked to both entities. These include myoclonus, opsoclonus-myoclonus syndrome, stiff-person syndrome, dystonia, chorea and parkinsonism. Their recognition can contribute to early diagnosis. Early diagnosis is crucial for the detection and treatment of the tumor in classical paraneoplastic syndromes, which can lead, if not to improvement, at least to the stabilization of the disease. It may also to prove to be a lifesaver for the patient. In celiac disease, on the other hand, early diagnosis and initiation of a gluten-free diet can even lead to reversal of the syndrome. For refractory cases, there is the possibility of immunological and symptomatic treatment. In this article, we present a typical case of paraneoplastic syndrome, a patient with paraneoplastic cerebellar degeneration in the context of anti-Yo antibodies. We also provide an overview of the etiology, clinical picture, diagnosis and treatment of classic paraneoplastic syndromes and celiac disease.