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Neuropathies associated with malignancy

A A Amato1, M P Collins

  • 1Department of Medicine/Neurology, University of Texas Health Science Center at San Antonio 78284, USA.

Seminars in Neurology
|May 1, 1998
PubMed
Summary
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Malignancy-associated peripheral neuropathies stem from cancer effects, paraneoplastic syndromes, or treatment toxicity. Understanding these causes is crucial for diagnosing and managing nerve disorders in cancer patients.

Area of Science:

  • Neurology
  • Oncology

Background:

  • Peripheral neuropathies are common in cancer patients.
  • These nerve disorders arise from direct tumor effects, remote paraneoplastic phenomena, or iatrogenic causes.
  • Specific nerve syndromes include cranial neuropathies, radiculopathies, plexopathies, and various polyneuropathies.

Purpose of the Study:

  • To review the mechanisms and clinical presentations of peripheral neuropathies in patients with malignancy.
  • To highlight the differential diagnosis of nerve disorders in the context of cancer.
  • To discuss the role of paraneoplastic and treatment-related toxicities.

Main Methods:

  • Literature review of peripheral neuropathies associated with malignancy.
  • Categorization of neuropathies based on etiology: direct cancer effect, paraneoplastic effect, and iatrogenic effect.

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  • Discussion of specific nerve syndromes and their underlying mechanisms.

    • Main Results:

    • Peripheral neuropathies in malignancy are multifactorial, including direct invasion, paraneoplastic syndromes, and treatment toxicity.
    • Sensorimotor polyneuropathies are most frequent, but other patterns exist.
    • Chemotherapeutic agents like vinca alkaloids, cisplatin, and taxanes commonly induce dose-related, sensory-predominant neuropathies.

    Conclusions:

    • Peripheral nerve disorders in malignancy require careful evaluation to determine the underlying cause.
    • Paraneoplastic mechanisms, though uncommon, are important considerations, particularly with small-cell lung cancer.
    • Toxic neuropathies from chemotherapy are often reversible and dose-dependent, with suramin presenting a unique demyelinating pattern.