Vineet Kwatra1, Michail Charakidis2, Narayan V Karanth2. 1. Medical Oncology Department, Alan Walker Cancer Centre, Royal Darwin Hospital, Northern Territory, Australia. v.kwatra@aoah.com.au. 2. Medical Oncology Department, Alan Walker Cancer Centre, Royal Darwin Hospital, Northern Territory, Australia.
Abstract
BACKGROUND: Paraneoplastic neurological syndrome is an immune-mediated phenomenon where antibodies from tumor cells are produced against neuronal proteins. Amphiphysin antibody is an onconeural antibody linked to the diagnosis of breast cancer and small-cell lung cancer. It is uncommon and typically associated with stiff-person syndrome, of which 90% of patients are eventually diagnosed with breast cancer. CASE PRESENTATION: We present a case of a 47-year-old Caucasian woman with metastatic hormone receptor-positive breast cancer who developed bilateral facial nerve palsy while on treatment with nab-paclitaxel. The patient was found to have anti-amphiphysin antibody in the serum and cerebrospinal fluid. She was treated with methylprednisolone and intravenous immunoglobulin, which resulted in partial improvement in her facial nerve palsy. CONCLUSIONS: This case highlights a rare presentation of bilateral facial nerve palsy that likely related to paraneoplastic syndrome associated with the presence of anti-amphiphysin antibody.
BACKGROUND:Paraneoplastic neurological syndrome is an immune-mediated phenomenon where antibodies from tumor cells are produced against neuronal proteins. Amphiphysin antibody is an onconeural antibody linked to the diagnosis of breast cancer and small-cell lung cancer. It is uncommon and typically associated with stiff-person syndrome, of which 90% of patients are eventually diagnosed with breast cancer. CASE PRESENTATION: We present a case of a 47-year-old Caucasian woman with metastatic hormone receptor-positive breast cancer who developed bilateral facial nerve palsy while on treatment with nab-paclitaxel. The patient was found to have anti-amphiphysin antibody in the serum and cerebrospinal fluid. She was treated with methylprednisolone and intravenous immunoglobulin, which resulted in partial improvement in her facial nerve palsy. CONCLUSIONS: This case highlights a rare presentation of bilateral facial nerve palsy that likely related to paraneoplastic syndrome associated with the presence of anti-amphiphysin antibody.
Authors: A Saiz; J Dalmau; M H Butler; Q Chen; J Y Delattre; P De Camilli; F Graus Journal: J Neurol Neurosurg Psychiatry Date: 1999-02 Impact factor: 10.154
Authors: F Graus; J Y Delattre; J C Antoine; J Dalmau; B Giometto; W Grisold; J Honnorat; P Sillevis Smitt; Ch Vedeler; J J G M Verschuuren; A Vincent; R Voltz Journal: J Neurol Neurosurg Psychiatry Date: 2004-08 Impact factor: 10.154
Authors: F Folli; M Solimena; R Cofiell; M Austoni; G Tallini; G Fassetta; D Bates; N Cartlidge; G F Bottazzo; G Piccolo; P De Camilli Journal: N Engl J Med Date: 1993-02-25 Impact factor: 91.245