A 70-year-old woman developed paraneoplastic cerebellar degeneration (PCD) due to P/Q-type and N-type voltage-gated calcium channel antibodies and small cell lung cancer, the main clinical manifestations of which were severe positioning vertigo and vomiting. Loss of the visual suppression of caloric nystagmus, spontaneous downbeat nystagmus, periodic alternating nystagmus, and positioning vertigo in our patient most probably corresponds to the cerebellar flocculus/paraflocculus lesion caused by PCD.
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Ogawa, E., Sakakibara, R., Kawashima, K. et al. VGCC antibody-positive paraneoplastic cerebellar degeneration presenting with positioning vertigo. Neurol Sci 32, 1209–1212 (2011). https://doi.org/10.1007/s10072-011-0648-7