Subacute sensory neuropathy: A remote effect of carcinoma

Horwich, Mark S.; Cho, Lucy; Porro, Robert S.; Posner, Jerome B.

doi:10.1002/ana.410020103

Cited by 199 publications

(78 citation statements)

References 29 publications

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“…Subacute sensory neuronopathy is an uncommon disorder that is probably paraneoplastic in about 20% of patients [75,76]. The symptoms begin with pain and paraesthesia.…”

Section: Subacute Sensory Neuronopathymentioning

confidence: 99%

Managing Paraneoplastic Neurological Disorders

2006

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“…Subacute sensory neuronopathy is an uncommon disorder that is probably paraneoplastic in about 20% of patients [75,76]. The symptoms begin with pain and paraesthesia.…”

Section: Subacute Sensory Neuronopathymentioning

confidence: 99%

Managing Paraneoplastic Neurological Disorders

2006

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“…Subacute sensory neuropathy is often associated with malignant tumors, most of which are small cell lung cancer (SCLC) (1). It is also called paraneoplastic sensory neuropathy (PSN).…”

Section: Introductionmentioning

confidence: 99%

Improvement of Anti-Hu-associated Paraneoplastic Sensory Neuropathy after Chemoradiotherapy in a Small Cell Lung Cancer Patient.

et al. 2001

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A 66-year-old man developed progressive painful dysesthesia in his hands and feet over 3 months. His vibration sense was impaired and sensory nerve action potentials of the limbs were not evoked. Biopsy of the peroneal nerve revealed sensory neuropathy. Positive anti-Hu antibody facilitated delineation of a right hilar mass and a metastatic lymph node in thoracic CT scan. He was diagnosed as small cell lung cancer associated with paraneoplastic sensory neuropathy. A complete response was achieved through chemotherapy (carboplatin and etoposide) and subsequent radiation therapy. Notably, his neurological conditions, although not changed during the hospitalization, gradually improved afterwards.

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“…GNP are a distinctive group of peripheral nervous system diseases and may be the first manifestation of systemic disorders, such as cancer and Sjögren' s syndrome 10,11 . In clinical practice, GNP must be differentiated from sensory PNP, but this is not always a simple task.…”

Section: Discussionmentioning

confidence: 99%

Ulnar sensory-motor amplitude ratio: a new tool to differentiate ganglionopathy from polyneuropathy

Garcia

Ricardo

Horta

et al. 2013

Arq. Neuro-Psiquiatr.

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Ganglionopathies (GNP), also known as sensory neuronopathies, are a group of conditions characterized by primary and selective damage to the dorsal root ganglia (DRG) of the spinal cord and sensory nuclei of the brainstem 1,2 . The etiologies are diverse and include immune-mediated diseases, vitamin deficiencies, drug toxicity, paraneoplastic syndromes and genetic causes, but many patients are yet defined as idiopathic 1,2 . The clinical presentation is characterized by diffuse, often asymmetric, sensory deficits and marked ataxia due to loss of proprioception 1,2 .In neurological practice, it is important to differentiate GNP from polyneuropathies (PNP) because the etiologies, therapeutic strategies and prognosis are often diverse 3 . Clinically, GNP can be distinguished from PNP due to a purely sensory dysfunction and the absence of length-dependent gradient of involvement. Often it is not possible to define a clear pattern of symmetry or predominant distal involvement (either by clinical or electrophysiological criteria), making it difficult to distinguish a GNP from a sensory PNP. ABSTRACTThe objective of this study was to evaluate if the ratio of ulnar sensory nerve action potential (SNAP) over compound muscle action potential (CMAP) amplitudes (USMAR) would help in the distinction between ganglionopathy (GNP) and polyneuropathy (PNP). Methods: We reviewed the nerve conductions studies and electromyography (EMG) of 18 GNP patients, 33 diabetic PNP patients and 56 controls. GNP was defined by simultaneous nerve conduction studies (NCS) and magnetic resonance imaging (MRI) abnormalities. PNP was defined by usual clinical and NCS criteria. We used ANOVA with post-hoc Tukey test and ROC curve analysis to compare ulnar SNAP and CMAP, as well as USMAR in the groups. Results: Ulnar CMAP amplitudes were similar between GNP x PNP x Controls (p=0.253), but ulnar SNAP amplitudes (1.6±3.2 x 11.9±9.1 x 45.7±24.7) and USMAR values (0.3±0.3 x 1.5±0.9 x 4.6±2.2) were significantly different. A USMAR threshold of 0.71 was able to differentiate GNP and PNP (94.4% sensitivity and 90.9% specificity). Conclusions: USMAR is a practical and reliable tool for the differentiation between GNP and PNP.Key words: clinical neurophysiology, ganglionopathy, polyneuropathy, sensory neuronopathy, ulnar nerve. RESUMOO objetivo deste estudo foi avaliar se a razão entre as amplitudes dos potenciais de ação sensitivo (SNAP) e motor (CMAP) do nervo ulnar (USMAR) auxiliaria na distinção entre ganglionopatia (GNP) e polineuropatia (PNP). Métodos: Revisamos os estudos de neurocondução e eletromiografia de 18 pacientes com GNP, 33 com PNP diabética e 56 controles. GNP foi definida pela presença simultânea de anormalidades na neurocondução e na ressonância magnética cervical. PNP foi definida por critérios clínicos e neurofisiológicos usuais. Usamos o teste ANOVA com Tukey post-hoc e análise da curva ROC para comparar o SNAP e CMAP ulnares, assim como o USMAR entre os grupos. Resultados: As amplitudes dos CMAPs ulnares foram similares entre GNP x P...

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Subacute sensory neuropathy: A remote effect of carcinoma

Cited by 199 publications

References 29 publications

Managing Paraneoplastic Neurological Disorders

Managing Paraneoplastic Neurological Disorders

Improvement of Anti-Hu-associated Paraneoplastic Sensory Neuropathy after Chemoradiotherapy in a Small Cell Lung Cancer Patient.

Ulnar sensory-motor amplitude ratio: a new tool to differentiate ganglionopathy from polyneuropathy

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