Paraneoplastic Neurologic Syndromes
Paraneoplastic neurologic syndromes are an extensive
group of neurologic disorders that occur in patients
with cancer and can affect any part of the nervous
system (see below). In most patients the neurologic
symptoms develop before the presence of the cancer
is known. Because of this and because the paraneoplastic
symptoms can mimic other cancer and non-cancer
related neurologic problems, the diagnosis of
paraneoplastic syndromes is difficult and can
be delayed while the patient is being tested for
other possible disorders.
However, patients with paraneoplastic syndromes
often develop specific serum or spinal fluid antibodies.
Detection of these antibodies indicates that the
patient’s symptoms are paraneoplastic and
can lead to the identification of the tumor at
early stage of the disease, when the tumor is
curable. The Neuro-oncology team at Penn is recognized
as a leader in the diagnosis and treatment of
these disorders.
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-man syndrome
Syndrome of the dorsal root ganglia
Multiple levels of involvement
- Encephalomyelitis*, sensory neuronopathy,
autonomic dysfunction
Syndromes of the peripheral nerve
- Chronic and subacute sensorimotor peripheral
neuropathy
- Vasculitis of the 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
*Includes cortical, limbic or
brainstem encephalitis, cerebellar dysfunction,
myelitis.
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