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Paraneoplastic movement disorders

Shyamal H Mehta1, John C Morgan, Kapil D Sethi

  • 1Movement Disorders Program, Department of Neurology, Augusta, GA 30912, USA. shmehta@mcg.edu

Current Neurology and Neuroscience Reports
|June 12, 2009
PubMed

Insights

Neurologic paraneoplastic syndromes (NPSs) are rare immune-mediated disorders triggered by cancer. This review focuses on paraneoplastic movement disorders and their link to underlying malignancy and immunotherapy.

Area of Science:

  • Neurology
  • Oncology
  • Immunology

Background:

  • Neurologic paraneoplastic syndromes (NPSs) arise from the nervous system's remote reaction to cancer, distinct from metastasis or infection.
  • These rare conditions affect approximately 1 in 10,000 cancer patients, driven by immune responses mistaking neural tissue for tumor antigens.

Purpose of the Study:

  • To review paraneoplastic movement disorders, including ataxia, stiff-person syndrome, opsoclonus-myoclonus syndrome, chorea, parkinsonism, and tremor.
  • To discuss the recently identified paraneoplastic anti-N-methyl-D-aspartate receptor encephalitis, characterized by complex movements and neurological signs.

Main Methods:

  • Literature review focusing on classic and emerging NPSs.
  • Analysis of pathogenesis, clinical manifestations, and treatment strategies.

Main Results:

  • NPSs involve immune-mediated damage to neural tissue due to shared onconeural antigens.
  • Paraneoplastic movement disorders encompass a range of conditions, including cerebellar degeneration, stiff-person syndrome, and encephalitis.

Conclusions:

  • Treatment and prognosis of NPSs are significantly influenced by the management of the primary cancer.
  • Immunotherapy plays a crucial role in managing these complex neurological disorders.

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