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Published on: November 29, 2019
Cerebrospinal fluid study in paraneoplastic syndromes
D Psimaras1, A F Carpentier, C Rossi
1AP-HP, Groupe Hospitalier Pitié Salpetrière, Service of Neurology Mazarin, UPMC, INSERM, Paris, France.
Cerebrospinal fluid (CSF) inflammation is common in paraneoplastic neurological syndromes (PNS). Early CSF analysis within 3 months of symptom onset aids diagnosis and may correlate with better survival in anti-Hu positive patients.
Area of Science:
- Neurology
- Immunology
- Oncology
Background:
- Paraneoplastic neurological syndromes (PNS) arise from immune responses targeting shared antigens between tumors and the nervous system.
- Characterizing cerebrospinal fluid (CSF) alterations is crucial for understanding PNS pathogenesis.
Purpose of the Study:
- To investigate CSF abnormalities in a large cohort of patients with paraneoplastic neurological syndromes.
- To determine the diagnostic utility of CSF analysis in PNS.
Main Methods:
- Retrospective analysis of clinical data from 295 PNS patients in the PNS European database (2000-2007).
- Inclusion criteria: definite PNS with specific antibody markers (anti-Hu, anti-Yo, etc.), available clinical data, and CSF study.
- CSF analysis included cell counts, protein levels, and oligoclonal bands.
Main Results:
- 93% of patients exhibited abnormal CSF findings (pleiocytosis, high protein, or oligoclonal bands).
- Early CSF analysis (within 3 months) showed higher rates of pleiocytosis (47% vs. 28%).
- Oligoclonal bands were the sole abnormality in 10% of cases; anti-Hu patients with high pleiocytosis had improved survival.
Conclusions:
- CSF inflammation is a prevalent finding in PNS.
- Early CSF analysis is a valuable diagnostic aid for PNS, particularly within the first three months of neurological symptom onset.
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