Paraneoplastic Myeloneuropathies: Clinical, Oncologic, and Serologic Accompaniments.

Area of Science:

• Neurology
• Oncology
• Immunology

Background:

• Paraneoplastic neurologic syndromes (PNS) are rare but serious complications of cancer.
• Myeloneuropathy, affecting both the spinal cord and peripheral nerves, can be an early manifestation of PNS.

Purpose of the Study:

• To investigate the clinical, radiologic, and serologic features of myeloneuropathy as a presenting phenotype of paraneoplastic neurologic syndromes.
• To identify key characteristics that may aid in early diagnosis and treatment.

Main Methods:

• Retrospective review of 32 patients with concomitant paraneoplastic spinal cord and peripheral nervous system involvement.
• Analysis of clinical data, neuroimaging (MRI), and serologic testing for onconeural antibodies.

Main Results:

• The study identified 32 patients with paraneoplastic myeloneuropathy, predominantly women (63%) with a median age of 61.
• Common symptoms included asymmetric paresthesias (84%), neuropathic pain (78%), subacute onset (72%), and sensory ataxia (69%).
• MRI revealed longitudinally extensive spinal cord lesions (45%) and nerve root enhancement (38%). Combined therapy improved functional outcomes (modified Rankin Scale scores).

Conclusions:

• Subacute myeloneuropathies warrant consideration for paraneoplastic etiologies.
• Recognizing the distinct features of paraneoplastic myeloneuropathy can facilitate earlier cancer detection and prompt immunosuppressive therapy.