Objective:To describe a rare case of a paraneoplastic neurological syndrome associated with tonsillar squamous cell carcinoma.Design: Case report. Patient:A 51-year-old female patient with paraneoplastic neurological disorder characterized by rapid and progressive bilateral facial paresis, diplopia, arm and leg weakness and paresthesia.Interventions: Symptomatic therapy for pain, surgery and radiotherapy for cancer. Main outcome measures:Medical fi le, radiological imaging, EMNG, immunological fi ndings and surgical report. Results:Patient neurological status drastically improved in early postoperative period (after primary surgical intervention). Only mild right facial paresis persisted upon release from hospital. Patient is scheduled for radiotherapy.Conclusion: This is to our knowledge fi rst case of paraneoplastic neurogical syndrome with demyelinating polyradiculoneuropathy associated with tonsillar carcinoma. In a case of an early staged carcinoma, symptomatic therapy and surgery alleviated or slowed progression of symptoms.