{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T20:08:57Z","timestamp":1778098137518,"version":"3.51.4"},"reference-count":11,"publisher":"American Academy of Audiology","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["j am acad audiol"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Paraneoplastic cerebellar degeneration (PCD) is a rare neurological disorder caused by tumor-mediated antibodies targeting the cerebellum, often leading to irreversible cerebellar damage. The most common antibody implicated in PCD is anti-Purkinje cell cytoplasmic\n antibody type-1, associated with malignancies such as breast, gynecological, and lung cancers. Symptoms often include dizziness, imbalance, progressive ataxia, and other cerebellar signs\/symptoms, but early presentations may mimic acute vestibular syndrome, thus complicating diagnosis.\n                    <jats:bold>Purpose:<\/jats:bold>\n                    To present a case of PCD and demonstrate how objective vestibular test results facilitated the management of the patient\u2019s medical care.\n                    <jats:bold>Research Design:<\/jats:bold>\n                    Case report.\n                    <jats:bold>Case Presentation:<\/jats:bold>\n                    A 67-year-old female with a history\n of left breast cancer presented with acute dizziness, imbalance, and left-sided lower-extremity weakness. The patient was referred for objective vestibular testing at the request of her internal medicine doctor.\n                    <jats:bold>Results:<\/jats:bold>\n                    Vestibular testing revealed continuous down-beating\n nystagmus and abnormal video head impulse test (vHIT) findings of the posterior canals only. Findings and history raised concern for central vestibular origin. Subsequent neurological evaluations revealed progressive cerebellar dysfunction. After a long medical journey, anti-Yo antibodies\n were detected, confirming a diagnosis of PCD.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    PCD can present with early vestibular symptoms, such as vertigo and dizziness, and as a result of damage to Purkinje cells in the cerebellum. This damage extends to the central vestibular system structures, which\n can lead to down-beating nystagmus and impaired vestibular-ocular reflex function as evident by vHIT findings. Early vestibular testing can play a role in the diagnosis, particularly when accompanied by a detailed cancer history.\n                    <jats:bold>Clinical Relevance Statement:<\/jats:bold>\n                    Given the\n rapid disease progression of PCD, it is crucial for clinicians conducting vestibular testing to understand signs of central nervous system involvement and refer patients promptly for neurological evaluation.\n                  <\/jats:p>","DOI":"10.3766\/jaaa.250011","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T06:05:48Z","timestamp":1757570748000},"page":"72-77","source":"Crossref","is-referenced-by-count":1,"title":["A Rare Presentation of Dizziness: Vestibular Testing in Paraneoplastic Cerebellar Degeneration"],"prefix":"10.3766","volume":"37","author":[{"given":"Evalena","family":"Behr","sequence":"first","affiliation":[{"name":"*Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie A.","family":"Honaker","sequence":"additional","affiliation":[{"name":"*Cleveland Clinic Foundation, Cleveland, OH"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2087","reference":[{"issue":"(2)","key":"c1","first-page":"217","article-title":"Paraneoplastic cerebellar ataxia and the paraneoplastic syndromes","volume":"28","year":"2015","journal-title":"Baylor University Medical Center Proceedings"},{"issue":"(4)","key":"c2","first-page":"621","article-title":"Vertical vestibular responses to head impulses are symmetric in downbeat nystagmus","volume":"63","year":"2004","journal-title":"Neurology"},{"key":"c3","volume-title":"Diagnostic Vestibular Pocket Guide: Evaluation of Dizziness, Vertigo, and Imbalance","year":"2021"},{"key":"c4","doi-asserted-by":"crossref","first-page":"960584","DOI":"10.3389\/fneur.2022.960584","article-title":"Case report: Acute vestibular syndrome and cerebellitis in anti-Yo paraneoplastic syndrome","volume":"13","year":"2022","journal-title":"Frontiers in Neurology"},{"issue":"(1)","key":"c5","first-page":"24","article-title":"Paraneoplastic cerebellar degeneration presented as acute vertigo","volume":"21","year":"2022","journal-title":"Research in Vestibular Science"},{"issue":"(17)","key":"c6","first-page":"4423","article-title":"Anti-Yo antibody-positive paraneoplastic cerebellar degeneration in a patient with possible cholangiocarcinoma: a case report and review of the literature","volume":"9","year":"2021","journal-title":"World Journal of Clinical Cases"},{"issue":"(1)","key":"c4151441","first-page":"143\u2013","article-title":"Prolonged asymmetric smooth-pursuit stimulation leads to downbeat nystagmus in healthy human subjects","volume":"46","year":"2005","journal-title":"Investigative Ophthalmology & Visual Science"},{"issue":"(6)","key":"c336704234","first-page":"1287\u2013","article-title":"A systematic review on anti-Yo\/PCA-1 antibody: Beyond cerebellar ataxia in middle-aged women with gynecologic cancer","volume":"22","year":"2023","journal-title":"Cerebellum"},{"issue":"(18)","key":"c7","first-page":"1690","article-title":"Paraneoplastic cerebellar degeneration: I. A clinical analysis of 55 anti-Yo antibody-positive patients","volume":"77","year":"2011","journal-title":"Neurology"},{"issue":"(6)","key":"c5420313","first-page":"405\u2013","article-title":"Eye movement disorders and the cerebellum","volume":"36","year":"2019","journal-title":"Journal of Clinical Neurophysiology"},{"issue":"(8)","key":"c8","first-page":"655","article-title":"Paraneoplastic cerebellar degeneration with anti-Yo antibodies\u2014a review","volume":"3","year":"2016","journal-title":"Annals of Clinical and Translational Neurology"}],"container-title":["Journal of the American Academy of Audiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/aaa\/jaaa\/2026\/00000037\/00000001\/art00008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T04:31:25Z","timestamp":1773203485000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.3766\/jaaa.250011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,1]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,1]]}},"alternative-id":["1050-0545(20260101)37:1L.72;1-"],"URL":"https:\/\/doi.org\/10.3766\/jaaa.250011","relation":{},"ISSN":["1050-0545"],"issn-type":[{"value":"1050-0545","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1,1]]}}}