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A 23-year-old nonsmoking man presented with difficulty walking, numbness, and weakness progressing over several months. By the time of presentation, the patient was not ambulatory. He was afebrile with normal vital signs and general examination. Neurologic examination demonstrated normal vision, mildly decreased strength, and severely diminished sensation to vibration and proprioception in both lower extremities. His temperature and pinprick sensation were mildly diminished in both legs and arms. Reflexes were diffusely diminished but not absent. He exhibited significant dysmetria in both upper and lower extremities. No tremor or other abnormal movements were noted.

Encephalomyeloneuropathy with CRMP-5 antibodies in a patient with a primary mediastinal serinoma