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Paraneoplastic opsoclonus: a neuropathologic study of two cases.
M T Giordana1, R Soffietti, D Schiffer
1II Neurological Clinic, University of Turin, Torino, Italy.
Clinical Neuropathology
|November 1, 1989
Summary
Opsoclonus, a rare neurological disorder, can be an early indicator of lung cancer. Neuropathological findings suggest an inflammatory remote effect of cancer, distinct from cerebellar degeneration.
Area of Science:
- Neurology
- Oncology
- Pathology
Background:
- Opsoclonus is an infrequent neurological paraneoplastic syndrome.
- Association between opsoclonus and malignant neoplasia is rare.
Observation:
- Two patients presented with opsoclonus and ataxia preceding bronchial carcinoma diagnosis by 7 and 11 months.
- Neuropathological examination revealed Purkinje cell loss, dentate nucleus edema, and peridental demyelination.
- No brain metastases or inflammatory signs were identified.
Findings:
- Cerebellar changes are attributed to paraneoplastic cerebellar degeneration, separate from opsoclonus origins.
- Opsoclonus is considered a remote inflammatory effect of cancer.
- Hypothesized mechanisms include neurotoxic and immunological pathways.
Implications:
- Early detection of opsoclonus may aid in identifying occult malignancies.
- Understanding the inflammatory and immunological basis of paraneoplastic opsoclonus is crucial for diagnosis and treatment.
- Further research into neurotoxic and immunological mechanisms is warranted.