Paraneoplastic neurological syndromes associated with lymphomas

We describe two patients who developed paraneoplastic neurological syndromes and have reviewed the literature. One patient with Hodgkin's disease developed brachial neuritis. The other with a non Hodgkin's lymphoma of thyroid suffered from ataxia owing to cerebellar degeneration. Both neurological syndromes developed following marked nodal shrinkage following chemotherapy. Although both patients are in complete remission there has been no recovery of the neurological deficit. The patient with brachial neuritis developed L'hermitte's sign after a modest dose radiation (35Gy in 20 fractions) to the cervical cord and a vincristine sensory neuropathy. Vincristine may also have increased the degree of ataxia in the second patient. We suggest that potentially neurotoxic treatment should be given with extra care to patients with paraneoplastic neurological disorders.