BackgroundParaneoplastic neurologic syndromes are neurologic disorders associated with cancer unrelated to metastatic, metabolic, or infectious complications. These symptoms usually precede the diagnosis of cancer.CasesCerebellar dysfunction was diagnosed in two women. Both patients presented with an extremely high titer of anti-Purkinje-cell antibodies (1:983,040 and 1:30,720). Ovarian and fallopian tube cancer was diagnosed. In the first patient, abdominal computed tomography (CT) and pelvic examination revealed a large pelvic mass, and surgical resection revealed stage III adenocarcinoma of the ovary. In the second patient, no tumor could be detected by examination, laboratory evaluation, or radiography. Laparotomy revealed a 1-cm left fallopian tube cancer with a small omental metastasis. Despite aggressive therapy, the patients' neurologic symptoms did not improve.ConclusionPatients with cerebellar dysfunction should be tested for anti-Purkinje-cell antibodies. If antibodies are positive, these patients should undergo careful evaluation for occult gynecologic cancer. Exploratory laparotomy, not laparoscopy, is the way to accurately diagnose, stage, and treat these patients.