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폐암환자에서 신생물딸림 증후군의 초기 증상으로 나타난 보행장애

Gait Disturbance as an Initial Manifestation of the Paraneoplastic Neurologic Syndrome in a Patient with Lung Cancer

대한근전도전기진단의학회지 2020년 22권 2호 p.90 ~ 94
이현성, 김창범, 김은석, 정한영, 박찬혁, 김창환, 이주성,
소속 상세정보
이현성 ( Lee Hyun-Sung ) - Inha University School of Medicine Department of Physical & Rehabilitation Medicine
김창범 ( Kim Chang-Beom ) - Inha University School of Medicine Department of Physical & Rehabilitation Medicine
김은석 ( Kim Eun-Suk ) - Inha University School of Medicine Department of Physical & Rehabilitation Medicine
정한영 ( Jung Han-Young ) - Inha University School of Medicine Department of Physical & Rehabilitation Medicine
박찬혁 ( Park Chan-Hyuk ) - Inha University School of Medicine Department of Physical & Rehabilitation Medicine
김창환 ( Kim Chang-Hwan ) - Inha University School of Medicine Department of Physical & Rehabilitation Medicine
이주성 ( Lee Joo-Sung ) - Inha University School of Medicine Department of Pathology

Abstract


We report a patient with clinical presentation of Lambert-Eaton myasthenic syndrome (LEMS) and paraneoplastic cerebellar degeneration (PCD) prior to the diagnosis of small cell lung cancer (SCLC). A sixty-year-old man suffered from subacute dizziness, ataxia, dysarthria, ptosis, and proximal weakness of limbs. A repetitive nerve stimulation (RNS) test showed a decremental responses at low-frequency (LF) stimulation and an incremental responses at high-frequency (HF) stimulation, suggesting the pattern of LEMS. There was no evidence of a specific lesion on brain magnetic resonance imaging (MRI), so we concluded his cerebellar ataxia, nystagmus and dysarthria were caused by PCD. We suspected that the PCD was coexistent with LEMS as a paraneoplastic neurological syndrome (PNS) associated with SCLC. Initial screening for cancer was negative; however, SCLC was detected through computed tomography of the thorax at four-months follow-up. Early recognition of PNS and repeated screening tests can lead to a timely diagnosis and earlier initiation of treatment of SCLC.

키워드

Paraneoplastic syndromes, Nervous system; Lambert-Eaton myasthenic syndrome; Small cell lung cancer

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