Abstract
Paraneoplastic syndrome is a syndrome caused by the remote and non-metastatic effects of cancer and can present with neurological signs and symptoms. This is a case report of a sixty-five-year-old patient who presented with agitation, confusion and slurred speech, found to have positive anti-neuronal nuclear antibodies (ANNA2) consistent with Paraneoplastic syndrome and was later diagnosed with sigmoid adenocarcinoma with para-aortic lymph node involvement. This presentation of colon cancer is a rare occurrence that the author felt should be looked at in detail.