Practical Neurology

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Practical Neurology 2007;7:336-341; doi:10.1136/jnnp.2007.129056
Copyright © 2007 by the BMJ Publishing Group Ltd.
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A difficult case

Anti-Hu syndrome: a rare presentation and a very difficult decision

Ursula Schulz, Specialist Registrar in Neurology1, Bryce Randalls, Consultant Anaesthetist in Intensive Care2, Carl Counsell, Clinical Senior Lecturer in Neurology1

1 Department of Neurology, Aberdeen Royal Infirmary, NHS Grampian University Hospitals NHS Trust, Aberdeen, UK
2 Department of Anaesthetics, Aberdeen Royal Infirmary, NHS Grampian University Hospitals NHS Trust, Aberdeen, UK

Correspondence to:
Correspondence to:
Dr U Schulz
Department of Neurology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, UK; ursula.schulz@nhs.net

The first 150 words of the full text of this article appear below.

Anti-Hu syndrome is the most commonly recognised paraneoplastic condition, typically characterised by a sensory neuropathy or a cerebellar syndrome.1,2 We have recently looked after a patient who—unusually—presented with a rapidly progressive motor syndrome, who was both a diagnostic and an ethical challenge.

HISTORY AND EXAMINATION

A 64-year-old lady presented with a three-week history of painless increasing arm weakness, breathlessness and difficulty walking. By the time she was admitted to hospital her symptoms had deteriorated to the extent that she was unable to lift her arms to feed or to dress herself. She had also started to wear a soft collar because she was unable to hold her head up. Her illness had been preceded by a one-week prodrome of general fatigue and malaise. She had previously been well with no significant past history. She was a longstanding smoker of 50 pack-years.

On examination she looked unwell and was breathless at rest with paradoxical . . . [Full text of this article]


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EDITOR’S CHOICE
Charles Warlow
Practical Neurology 2007 7: 279. [Extract] [Full Text] [PDF]





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Copyright © 2007 by the BMJ Publishing Group Ltd.