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    Paraneoplastic disorders are autoimmune diseases linked to cancer, involving autoantibodies against neural proteins. Early diagnosis and immunotherapy are crucial for managing these diverse neurological syndromes.

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    Area of Science:

    • Neuroimmunology
    • Oncology
    • Autoimmune Diseases

    Background:

    • Paraneoplastic disorders are autoimmune conditions associated with specific cancers.
    • They manifest as diverse neurological syndromes affecting the central and peripheral nervous systems.
    • Specific autoantibodies are key diagnostic markers.

    Purpose of the Study:

    • To review the spectrum of paraneoplastic neurological disorders.
    • To discuss the underlying autoimmune mechanisms and associated cancers.
    • To highlight diagnostic approaches and therapeutic strategies.

    Main Methods:

    • Review of current literature on paraneoplastic neurological disorders.
    • Analysis of autoantibody targets and their clinical correlations.
    • Evaluation of treatment responses to immunotherapy.

    Main Results:

    • Peripheral nervous system autoimmunity to synaptic/axonal proteins is linked to cancer, often responding to immunotherapy (e.g., myasthenia gravis).
    • Classic paraneoplastic syndromes involve intracellular autoantibodies (e.g., Hu), T-cell mechanisms, CNS/PNS involvement, and poor treatment response.
    • Newer disorders feature antibodies to N-methyl-D-aspartate (NMDA) receptor and other synaptic proteins, showing favorable immunotherapy response.
    • Antibodies to intracellular synaptic proteins (e.g., GAD65) represent another category with uncertain mechanisms.

    Conclusions:

    • Neurologists must recognize paraneoplastic neurological syndromes.
    • Autoantibody testing and other diagnostics are essential for diagnosis.
    • Understanding disease pathology guides prompt and appropriate immunotherapy.