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Update on paraneoplastic neurologic disorders
Josep Dalmau1, Myrna R Rosenfeld
1Dr. Dalmau is Professor of Neurology, and Dr. Rosenfeld is Professor of Neurology and Chief of the Division of Neuro-oncology, at the University of Pennsylvania, Philadelphia.
Community Oncology
|May 17, 2011
Summary
Paraneoplastic neurologic disorders (PNDs) are increasingly recognized in cancer patients, often preceding cancer diagnosis. Early detection and treatment of PNDs are crucial for stabilizing or improving neurological function.
Area of Science:
- Neurology
- Oncology
- Immunology
Background:
- Paraneoplastic neurologic disorders (PNDs) were once considered rare but are now recognized as a significant group of neurological conditions associated with cancer.
- Increased recognition is largely due to the identification of specific antineuronal antibodies in patient serum and cerebrospinal fluid.
- While various neoplasms can cause PNDs, common associations include small-cell lung cancer, breast and ovarian cancers, thymoma, neuroblastoma, plasma cell tumors, and ovarian teratoma.
Purpose of the Study:
- To highlight the growing importance and recognition of paraneoplastic neurologic disorders (PNDs) in oncology.
- To emphasize the diagnostic challenge posed by PNDs, as neurological symptoms frequently precede cancer detection.
- To underscore the necessity of early diagnosis and intervention for potential neurological stabilization or improvement in affected patients.
Main Methods:
- Review of current literature and clinical observations regarding paraneoplastic neurologic disorders.
- Analysis of the role of antineuronal antibodies in the diagnosis and understanding of PNDs.
- Discussion of common associated neoplasms and diagnostic strategies for PNDs.
Main Results:
- PNDs are an extensive group of neurological disorders linked to cancer, occurring with increased frequency in cancer patients.
- Antineuronal antibodies have been pivotal in the increased recognition and diagnosis of PNDs.
- Neurologic symptoms of PNDs manifest before cancer diagnosis in over two-thirds of patients, complicating early detection.
Conclusions:
- Establishing a diagnosis of PND is critical, as it often serves as an early indicator of an underlying malignancy.
- In suspected PND cases where no tumor is initially found, periodic cancer screening (e.g., every 6 months) is recommended.
- Prompt diagnosis and therapeutic intervention in PND offer the best prognosis for neurological recovery or stabilization.
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