Related Experiment Videos
Paraneoplastic painful ulnar neuropathy
M K Sharief1, S F Robinson, D A Ingram
1Department of Neurology, Guy's, King's and St. Thomas's Medical School, Guy's Hospital, London SE1 9RT, U.K.
Muscle & Nerve
|July 9, 1999
Summary
A paraneoplastic neuropathy associated with small cell lung cancer and anti-Hu antibodies can mimic mononeuropathy. This case highlights the importance of considering paraneoplastic syndromes in neurological presentations.
Area of Science:
- Neurology
- Oncology
- Immunology
Background:
- Paraneoplastic neurological syndromes (PNS) are rare complications of cancer.
- Anti-Hu antibodies are frequently associated with small cell lung carcinoma (SCLC).
- Ulnar neuropathy is typically a focal entrapment or demyelinating process.
Observation:
- A 58-year-old woman presented with painful, bilateral ulnar neuropathy.
- She had co-existing small cell lung carcinoma and high serum anti-Hu antibody titers.
- An incidental stage I plasma cell dyscrasia was also noted.
Findings:
- Electrophysiological studies ruled out a generalized neuropathy.
- Nerve biopsy revealed significant loss of myelinated and small unmyelinated fibers.
- No inflammatory changes or amyloid deposition were observed in the nerve biopsy.
Implications:
- High anti-Hu antibody titers can manifest as a paraneoplastic mononeuropathy.
- This presentation underscores the diverse neurological manifestations of SCLC.
- Early recognition of paraneoplastic syndromes is crucial for timely cancer treatment and neurological management.