Paraneoplastic syndromes of the spinal cord, nerve, and muscle

Abstract

Cancer can affect the peripheral nervous system by non‐metastatic, sometimes immune‐mediated mechanisms. Recognition of these paraneoplastic syndromes is important because it can lead to the detection of the tumor, and also helps to avoid unnecessary studies to determine the cause of the neurologic symptoms in patients with cancer. Many paraneoplastic syndromes of the peripheral nervous system are not associated with serum antibodies that serve as markers of paraneoplasia. For this group of disorders the diagnosis depends on the clinician's index of suspicion and conventional electrophysiologic and laboratory tests. Treatment of the tumor, immunotherapy, or both may improve some of these syndromes. This review focuses on paraneoplastic syndromes of the spinal cord, peripheral nerve, and muscle. © 2000 John Wiley & Sons, Inc. Muscle Nerve 23: 1800–1818, 2000

A predominantly left upper limb sensory neuronopathy as a manifestation of a metastatic neuroendocrine malignancy

“…12,13 Paraneoplastic subacute sensory neuronopathies can occur without the presence of anti-neuronal (in particular, anti-Hu) antibodies. 1,2,14 After the tissue diagnosis was made, treatment options were discussed with the patient and her family. Further therapy was declined and palliative therapy was given.…”

“…Neurological manifestations are uncommon -about 1% for solid tumours other than small cell lung cancer. 1 Paraneoplastic syndromes manifesting as dorsal root ganglionopathies have been infrequently documented. 2, 3 We present a patient with a predominantly left upper limb sensory ganglionopathy who was discovered to have a neuroendocrine malignancy.…”

Anti-glutamic acid decarboxylase antibody positive neurological syndromes

“…Patients positive for anti-GAD antibodies are also seen in the neurological setting who subsequently develop cancer 26. Carcinoma of the breast, small cell lung carcinoma, thymoma, and various other types of cancers like Hodgkin’s lymphoma and colon cancer are found to be associated with paraneoplastic SPS 34-37. According to Tomioka et al,30 paraneoplastic SPS patients with breast cancer or small cell lung cancer have anti-amphiphysin antibodies.…”

Neurophysiological studies in malignant disease with particular reference to involvement of peripheral nerves

“…In the peripheral neuromuscular system, the involvement may be localized to motor or sensory nerve cell bodies (neuronopathies), somatic or autonomic pe- ripheral nerves, neuromuscular transmission or striated muscle (Tables 1, 2) [4, 51,52]. The types of malignancy associated with paraneoplastic neuromuscular disorders include several solid tumors as well as hematological malignancies.…”

“…Paraneoplastic neuropathy may be asymmetrical with features of mononeuritis multiplex with intestinal pseudo-obstruction [107], and vasculitis is found in rare cases [52,[109][110][111].…”