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Sporadic fatal insomnia is a rare prion disease that has recently been recognized. Objective: To report a unique case of sporadic fatal insomnia in a woman with progressive cerebellar deterioration who was originally thought to have a paraneoplastic cerebellar syndrome. Design: Case report describing a patient with autopsyproven sporadic fatal insomnia. Patient: A 56-year-old woman with progressive cerebellar ataxia who was found to have a retroperitoneal non-Hodgkin lymphoma. Results: Autopsydoi:10.1001/archneur.65.7.971 pmid:18625868 fatcat:6vehzlltp5b3hcxcwbjpfe56i4