Clinical Scenario

This protocol covers paraneoplastic cerebellar degeneration presenting as a rapidly progressive cerebellar syndrome in which antineuronal antibodies directed against cell-surface antigens have been detected. The distinction between cell-surface and intracellular antibody targets guides the selection of the appropriate therapeutic approach.

Treatment Approach (overview only)

First-line management prioritises early treatment of the underlying tumor — with the choice of oncological intervention depending on tumor entity, staging, and individual factors — alongside acute immunotherapy. The complete treatment sequence, agent selection, and bridging strategy are available in the full protocol.

References

DOI: 10.3390/brainsci11111414

If a specific antibody has been detected, one can distinguish between antibodies directed against intracellular antigens and antibodies directed against cell-surface antigens.
Concepts targeting B-cells alone are primarily used if antibodies against cell-surface antigens have been detected.
In most cases, treatment of the underlying oncological disorder is paramount for the treatment of the paraneoplastic syndrome as well.
Of course, choice of oncological treatment options (surgery, chemotherapy, radiotherapy) depends on tumor entity, staging, and individual aspects.
If a patient presents with a typical clinical syndrome and specific antineuronal antibodies are detected or suspected, acute therapeutical settings aim to reduce brain inflammation and levels of circulating antibodies.

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Treatment of Paraneoplastic Cerebellar Degeneration in Rapidly Progressive Cerebellar Syndrome with Cell-Surface Antineuronal Antibodies

References