Paraneoplastic autonomic neuropathies and GI dysmotility

Area of Science:

• Neurology
• Immunology
• Oncology

Background:

• Autoimmune and paraneoplastic neurologic syndromes often involve the autonomic nervous system.
• Autonomic dysfunction, particularly gastrointestinal dysmotility, can be a significant but overlooked symptom.
• Immune-mediated autonomic ganglionopathies and encephalitis demonstrate direct attacks on autonomic structures.

Approach:

• Clinical recognition of autonomic features is crucial for diagnosing autoimmune and paraneoplastic etiologies.
• Neurologic autoantibodies play a key role in confirming diagnoses and guiding malignancy investigations.
• Multifaceted management includes treating the underlying neoplasm, immunomodulatory therapies, and symptomatic relief.

Key Points:

• Autonomic nervous system involvement is common in autoimmune and paraneoplastic neurological disorders.
• Gastrointestinal dysmotility is a frequent and significant symptom that may be overlooked.
• Identifying autonomic dysfunction aids in diagnosing and managing these conditions.

Conclusions:

• Early identification of autonomic dysfunction is vital for diagnosing paraneoplastic and autoimmune neurological syndromes.
• Diagnostic evaluation and malignancy screening are guided by clinical presentation and autoantibody profiles.
• Comprehensive management requires addressing the primary neoplasm, modulating the immune response, and alleviating symptoms.