TAILIEUCHUNG - Chapter 097. Paraneoplastic Neurologic Syndromes

Paraneoplastic neurologic disorders (PNDs) are cancer-related syndromes that can affect any part of the nervous system (Table 97-1). They are remote effects of cancer, caused by mechanisms other than metastasis or by any of the complications of cancer such as coagulopathy, stroke, metabolic and nutritional conditions, infections, and side effects of cancer therapy. In 60% of patients the neurologic symptoms precede the cancer diagnosis. Overall, clinically disabling PNDs occur in –1% of all cancer patients, but they occur in 2–3% of patients with neuroblastoma or small cell lung cancer (SCLC), and in 30–50% of patients with thymoma or sclerotic. | Chapter 097. Paraneoplastic Neurologic Syndromes Paraneoplastic neurologic disorders PNDs are cancer-related syndromes that can affect any part of the nervous system Table 97-1 . They are remote effects of cancer caused by mechanisms other than metastasis or by any of the complications of cancer such as coagulopathy stroke metabolic and nutritional conditions infections and side effects of cancer therapy. In 60 of patients the neurologic symptoms precede the cancer diagnosis. Overall clinically disabling PNDs occur in of all cancer patients but they occur in 2-3 of patients with neuroblastoma or small cell lung cancer SCLC and in 30-50 of patients with thymoma or sclerotic myeloma. Table 97-1 Paraneoplastic Syndromes of the Nervous System Syndromes of the brain brainstem and cerebellum Focal encephalitis Cortical encephalitis Limbic encephalitis Brainstem encephalitis Cerebellar dysfunction Autonomic dysfunction Paraneoplastic cerebellar degeneration Opsoclonus-myoclonus Syndromes of the spinal cord Subacute necrotizing myelopathy Motor neuron dysfunction Myelitis Stiff-person syndrome Syndromes of dorsal root ganglia Sensory neuronopathy Multiple levels of involvement Encephalomyelitis 3 sensory neuronopathy autonomic dysfunction Syndromes of peripheral nerve Chronic and subacute sensorimotor peripheral neuropathy Vasculitis of nerve and muscle Neuropathy associated with malignant monoclonal gammopathies Peripheral nerve hyperexcitability Autonomic neuropathy Syndromes of the neuromuscular junction Lambert-Eaton myasthenic syndrome Myasthenia gravis Syndromes of the muscle Polymyositis dermatomyositis Acute necrotizing myopathy Syndromes affecting the visual system Cancer-associated retinopathy CAR Melanoma-associated retinopathy MAR Uveitis usually in association with encephalomyelitis includes cortical limbic or brainstem encephalitis cerebellar dysfunction myelitis. Pathogenesis Most PNDs are mediated by immune responses triggered by neuronal proteins .

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