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Optic neuropathy: a rare paraneoplastic syndrome
S Malik1, A J Furlan, P J Sweeney
1Department of Neurology, Cleveland Clinic Foundation, Ohio 44132.
Journal of Clinical Neuro-Ophthalmology
|September 1, 1992
Summary
Paraneoplastic optic neuropathy can cause vision loss in cancer patients. This case suggests an immune response against the nervous system may be involved.
Area of Science:
- Neurology
- Ophthalmology
- Oncology
Background:
- Paraneoplastic syndromes occur in patients with cancer and can affect the nervous system.
- Optic neuropathy, a dysfunction of the optic nerve, can lead to vision loss.
Observation:
- A 63-year-old man presented with progressive vision loss, cerebellar ataxia, and downbeat nystagmus.
- Ophthalmic examination revealed bilateral optic atrophy and visual field defects.
- Brain MRI was normal, but cerebrospinal fluid showed elevated protein and IgG.
Findings:
- Pulmonary small cell carcinoma was diagnosed via lymph node biopsy.
- Serum analysis detected IgG antibodies reacting with neuronal and glial tissues.
- The patient's tumor showed positivity for neuron-specific enolase.
Implications:
- This case highlights paraneoplastic optic neuropathy as a consideration in malignancy-associated visual impairment.
- The findings suggest a potential autoimmune mechanism underlying the optic neuropathy.
- Further research into immunologic targets in paraneoplastic syndromes is warranted.