Paraneoplastic syndromes

Clinical manifestations
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By Edward J Dropcho MD

Paraneoplastic disorders can affect any part of the central or peripheral nervous system (Graus et al 2004; Giometto et al 2010). Many patients can be grouped into a recognizable clinical syndrome predominantly affecting 1 anatomic location or system (Table 1), such as limbic encephalitis or cerebellar degeneration. Other patients do not neatly fit into this scheme, as they have signs and symptoms of more than 1 syndrome. One view is that most, if not all, paraneoplastic disorders are subsets of a diffuse and multifocal "paraneoplastic encephalomyelitis" or "paraneoplastic encephalomyeloneuritis" in which individual patients may show predominant involvement of particular parts of the nervous system (Graus et al 2001).

Table 1. Neurologic Paraneoplastic Disorders

 

Central nervous system

Peripheral nervous system

Multifocal encephalomyelitis

Sensory neuronopathy

Cerebellar degeneration

Nerve vasculitis

Limbic encephalitis

Sensorimotor polyneuropathy

Opsoclonus-myoclonus

Motor neuropathy

Extrapyramidal syndrome

Neuromyotonia

Brainstem encephalitis

Autonomic insufficiency

Myelopathy

Lambert-Eaton syndrome

Motor neuron disease

Myasthenia gravis

Stiff-person syndrome

Polymyositis/dermatomyositis

Optic neuritis

Necrotizing myopathy

Retinal degeneration

 

In This Article

Introduction
Historical note and nomenclature
Clinical manifestations
Etiology
Pathogenesis and pathophysiology
Epidemiology
Prevention
Differential diagnosis
Diagnostic workup
Prognosis and complications
Management
Anesthesia
References cited
Contributors