Prolonged Anti‐Zic4 Antibody–Positive Cerebellar Degeneration Following <scp>COVID</scp> ‐19 Infection

This case illustrates an unusual phenotype of prolonged, isolated anti-Zic4 antibody-associated cerebellar degeneration triggered by SARS-CoV-2 infection, thus expanding the recognized clinical spectrum of Zic4-related disorders beyond paraneoplastic contexts. The underlying immunopathological mechanisms have yet to be elucidated. Notably, radiological progression was disproportionate to clinical stabilization, underscoring the necessity of long-term clinical/imaging surveillance. This case highlights the need for further studies to clarify pathophysiological links between COVID-19 and persistent autoimmune cerebellar degeneration.