paraneoplastic polyneuropathy

Summary

Summary: A diffuse or multifocal peripheral neuropathy related to the remote effects of a neoplasm, most often carcinoma or lymphoma. Pathologically, there are inflammatory changes in peripheral nerves. The most common clinical presentation is a symmetric distal mixed sensorimotor polyneuropathy. (Adams et al., Principles of Neurology, 6th ed, p1334)

Top Publications

  1. Camdessanche J, Antoine J, Honnorat J, Vial C, Petiot P, Convers P, et al. Paraneoplastic peripheral neuropathy associated with anti-Hu antibodies. A clinical and electrophysiological study of 20 patients. Brain. 2002;125:166-75 pubmed
    ..In addition to their potential pathophysiological involvement in the mechanism of the paraneoplastic neuropathy, these findings have practical consequences for the diagnosis of the disorder...
  2. Pittock S, Lucchinetti C, Lennon V. Anti-neuronal nuclear autoantibody type 2: paraneoplastic accompaniments. Ann Neurol. 2003;53:580-7 pubmed
  3. Fujimoto S, Kumamoto T, Ito T, Sannomiya K, Inuzuka T, Tsuda T. A clinicopathological study of a patient with anti-Hu-associated paraneoplastic sensory neuronopathy with multiple cranial nerve palsies. Clin Neurol Neurosurg. 2002;104:98-102 pubmed
    ..Multiple cranial nerve palsies and their effects including the tonic pupil are likely due to the paraneoplastic effect of the primary systemic malignancy...
  4. Raaphorst J, Vanneste J. Numb cheek syndrome as the first manifestation of anti-Hu paraneoplastic neuronopathy. J Neurol. 2006;253:664-5 pubmed
  5. Lauria G, Sghirlanzoni A, Lombardi R, Pareyson D. Epidermal nerve fiber density in sensory ganglionopathies: clinical and neurophysiologic correlations. Muscle Nerve. 2001;24:1034-9 pubmed
  6. Graus F, Keime Guibert F, Rene R, Benyahia B, Ribalta T, Ascaso C, et al. Anti-Hu-associated paraneoplastic encephalomyelitis: analysis of 200 patients. Brain. 2001;124:1138-48 pubmed
    ..Finally, the predictors of mortality and PEM evolution found in the study may be important in the design of future therapeutic protocols, and emphasize the importance of early diagnosis and treatment of the underlying tumour...
  7. Kuntzer T, Antoine J, Steck A. Clinical features and pathophysiological basis of sensory neuronopathies (ganglionopathies). Muscle Nerve. 2004;30:255-68 pubmed
    ..The differential diagnosis involves separating sensory ganglionopathies from other ataxic polyneuropathies, such as infectious neuropathies, sensory neuropathies with various autoantibodies, and the neuropathies seen in celiac disease...
  8. Linke R, Schroeder M, Helmberger T, Voltz R. Antibody-positive paraneoplastic neurologic syndromes: value of CT and PET for tumor diagnosis. Neurology. 2004;63:282-6 pubmed
    ..To assess use of whole-body 18F fluoro-2-deoxy-glucose (FDG)-PET and CT for diagnosing tumor in patients with antibody-positive paraneoplastic neurologic syndromes (PNS)...
  9. Bataller L, Wade D, Graus F, Stacey H, Rosenfeld M, Dalmau J. Antibodies to Zic4 in paraneoplastic neurologic disorders and small-cell lung cancer. Neurology. 2004;62:778-82 pubmed
    ..To determine whether serum Zic4 antibodies associate with paraneoplastic neurologic disorders (PND) and small-cell lung cancer (SCLC), and the association of these antibodies with other onconeuronal immunities associated with SCLC...

More Information

Publications62

  1. Nakano S, Kanamori A, Nakamura M, Mizukawa K, Negi A. Paraneoplastic optic neuropathy associated with cerebellar choroid meningioma. Eye (Lond). 2013;27:1220-1 pubmed publisher
  2. Plonquet A, Gherardi R, Creange A, Antoine J, Benyahia B, Grisold W, et al. Oligoclonal T-cells in blood and target tissues of patients with anti-Hu syndrome. J Neuroimmunol. 2002;122:100-5 pubmed
    ..Taken together, these data support a direct effector role of cytotoxic CD8(+) T-cells, the same clones being likely operative in sensory neuron damage and immune-mediated tumor growth control...
  3. Roy M, May E, Jabbari B. Life-threatening polyneuropathy heralding renal cell carcinoma. Mil Med. 2002;167:986-9 pubmed
    ..To report the occurrence of life-threatening polyneuropathy in association with renal cell carcinoma...
  4. Kuntzer T. [Ganglionopathies: evolving concept and ideas on management]. Rev Neurol (Paris). 2006;162:1268-72 pubmed
    ..This review focuses on recent advances in defining the mechanisms involved in sensory ganglionopathies, and describes the differential diagnosis including the rarely encountered hereditary neuronopathies and the infectious causes...
  5. Rojas Marcos I, Rene R, Graus F. [Paraneoplastic syndromes in otoneuro-ophthalmology]. Rev Neurol. 2000;31:1206-12 pubmed
    ..We review the main NPNS paying particular attention to those with ophthalmological and otological features...
  6. Nickel J, Neuen Jacob E, Saleh A, Gattermann N, Hartung H, Koller H. CIDP and isolated osteosclerotic myeloma. Neurology. 2004;63:2439 pubmed
  7. Voltz R, Graus F. Diagnosis and treatment of paraneoplastic neurological disorders. Onkologie. 2004;27:253-8 pubmed
    ..It is hoped that the recent fundamental advances in understanding the autoimmune pathology of these disorders, especially the role of cytotoxic T cells, will eventually lead to more effective treatment options...
  8. Ansari J, Nagabhushan N, Syed R, Bomanji J, Bacon C, Lee S. Small cell lung cancer associated with anti-Hu paraneoplastic sensory neuropathy and peripheral nerve microvasculitis: case report and literature review. Clin Oncol (R Coll Radiol). 2004;16:71-6 pubmed
  9. Antoine J. [Paraneoplastic peripheral neuropathies]. Rev Neurol (Paris). 2008;164:1068-72 pubmed publisher
    ..Possible paraneoplastic neuropathies are heterogeneous. This classification is useful for the diagnostic of these disorders and the selection of patients in whom a search for cancer is warranted...
  10. Porto L, Miranda M, Gomes A, Andre R, Rodrigues B. Paraneoplastic neurological syndrome as an initial indicator of small cell carcinoma of the lung. BMJ Case Rep. 2013;2013: pubmed publisher
    ..Although rare, PNSs can be the first manifestations of cancer, and their rapid recognition facilitates an early treatment...
  11. Barua A, Gozzard P, Martin Ucar A, Maddison P. Neuronal antibodies and paraneoplastic sensory neuropathy in thymoma. Interact Cardiovasc Thorac Surg. 2012;15:516-7 pubmed publisher
    ..Subsequent minimally invasive thymomectomy improved her neurological symptoms significantly...
  12. Kloos L, Sillevis Smitt P, Ang C, Kruit W, Stoter G. Paraneoplastic ophthalmoplegia and subacute motor axonal neuropathy associated with anti-GQ1b antibodies in a patient with malignant melanoma. J Neurol Neurosurg Psychiatry. 2003;74:507-9 pubmed
    ..Immunohistochemically, the patient's IgM reacted with the tumour and co-localised with GQ1b. She improved neurologically following steroid treatment and became ambulatory...
  13. Bech C, Sørensen J. Polyneuropathy in a patient with malignant pleural mesothelioma: a paraneoplastic syndrome. J Thorac Oncol. 2008;3:1359-60 pubmed publisher
    ..We therefore suggest that polyneuropathy is a possible paraneoplastic syndrome in MPM...
  14. Finsterer J, Unterberger U, Grisold W. Asymptomatic persistence of anti-Yo antibodies for 5 years without relapse of malignancy. Neuropathology. 2007;27:300-4 pubmed
    ..Anti-Yo antibodies may occur without the typical clinical manifestations of a NPS and may persist for years without the development of a NPS or relapse of the tumor...
  15. Rajabally Y, Qaddoura B, Abbott R. Steroid-responsive paraneoplastic demyelinating neuropathy and myelopathy associated with breast carcinoma. J Clin Neuromuscul Dis. 2008;10:65-9 pubmed publisher
    ..Her condition did not progress further after cancer treatment. Partial neurologic improvement occurred with oral steroid therapy, with subsequent deterioration on treatment withdrawal...
  16. Obana T, Tanio Y, Takenaka M, Watanabe D, Yanagita M, Nakajima S, et al. [Chemotherapy for small-cell lung cancer (SCLC) patients with renal failure]. Gan To Kagaku Ryoho. 2002;29:435-8 pubmed
    ..Although chemotherapy is useful, further study is needed for the selection of suitable chemotherapeutic regimens, optimal dosage of each drug and the timing of HD...
  17. Krarup C, Crone C. Neurophysiological studies in malignant disease with particular reference to involvement of peripheral nerves. J Neurol. 2002;249:651-61 pubmed
    ..Even in cases where such studies are obtained, a final diagnosis may only be ascertained during follow up, since the neuromuscular disorders frequently occur before the neoplasm is detected...
  18. Noto Y, Shiga K, Fujinami J, Mizuno T, Nakagawa M, Tanaka K. [Subacute sensory neuronopathy associated with squamous cell carcinoma of the lung: a case report]. Rinsho Shinkeigaku. 2009;49:497-500 pubmed
    ..The early detection and the treatment of the primary tumor are crucial in a patient with subacute progression of sensory-dominant neuropathy...
  19. Camdessanche J, Jousserand G, Franques J, Pouget J, Delmont E, Creange A, et al. A clinical pattern-based etiological diagnostic strategy for sensory neuronopathies: a French collaborative study. J Peripher Nerv Syst. 2012;17:331-40 pubmed publisher
    ..The diagnostic strategy based on these patterns correctly identified 84/88 and 58/60 patients in the study and test populations, respectively...
  20. Au W, Mak W, Ho S, Leung S, Kwong Y. Reversible paraneoplastic neuropathy associated with T-cell large granular lymphocyte leukemia. Neurology. 2004;63:588-9 pubmed
  21. Karrasch T, Weil M, Voltz R, Schulz C, Audebert F, Woenckhaus M, et al. ["Tingling feet," forgetfulness, and progressive personality changes in a 63-year-old patient]. Internist (Berl). 2004;45:341-6 pubmed
    ..The prognosis of patients with paraneoplastic symptoms is the better the earlier a diagnosis is established and antitumor therapy is initiated...
  22. Darnell R, Posner J. Observing the invisible: successful tumor immunity in humans. Nat Immunol. 2003;4:201 pubmed
  23. Braik T, Evans A, Telfer M, McDunn S. Paraneoplastic neurological syndromes: unusual presentations of cancer. A practical review. Am J Med Sci. 2010;340:301-8 pubmed publisher
    ..Paraneoplastic neurological syndromes (PNS) are uncommon and imperfectly understood and, therefore, are frequently underdiagnosed...
  24. Rubio Agusti I, Perez Miralles F, Sevilla T, Muelas N, Chumillas M, Mayordomo F, et al. Peripheral nerve hyperexcitability: a clinical and immunologic study of 38 patients. Neurology. 2011;76:172-8 pubmed publisher
  25. Tojo K, Tokuda T, Yazaki M, Oide T, Nakamura A, Mitsuhashi S, et al. Paraneoplastic sensorimotor neuropathy and encephalopathy associated with anti-alpha-enolase antibody in a case of gastric adenocarcinoma. Eur Neurol. 2004;51:231-3 pubmed
  26. Heuss D. [Can prostatic carcinoma cause polyneuropathy?]. Dtsch Med Wochenschr. 2003;128:158 pubmed
  27. Hammam T, McFadzean R, Ironside J. Anti-hu paraneoplastic syndrome presenting as bilateral sixth cranial nerve palsies. J Neuroophthalmol. 2005;25:101-4 pubmed
    ..Four and half years after the onset of her diplopia, she died of diffuse metastatic breast cancer. This is the first reported case of anti-Hu paraneoplastic brain stem encephalitis presenting with sixth cranial nerve palsies...
  28. Uribe Uribe N, Jimenez Garduño A, Henson D, Albores Saavedra J. Paraneoplastic sensory neuropathy associated with small cell carcinoma of the gallbladder. Ann Diagn Pathol. 2009;13:124-6 pubmed publisher
    ..Anti-Hu paraneoplastic sensory neuropathy should be added to the list of paraneoplastic syndromes associated with small cell carcinoma of the gallbladder...
  29. Calvert P. A CR(I)MP in the optic nerve: recognition and implications of paraneoplastic optic neuropathy. J Neuroophthalmol. 2006;26:165-7 pubmed
  30. Gill S, Murray N, Dalmau J, Thiessen B. Paraneoplastic sensory neuronopathy and spontaneous regression of small cell lung cancer. Can J Neurol Sci. 2003;30:269-71 pubmed
    ..Spontaneous tumour regression in small cell lung cancer has previously been suggested in patients with paraneoplastic neurologic syndromes. Rare documentation of this event has occurred in the literature...
  31. Giovannoni G, Baker D. Inflammatory disorders of the central nervous system. Curr Opin Neurol. 2003;16:347-50 pubmed
  32. Itou T, Enomoto S, Makita Y, Enomoto H, Kuroda K, Kimura T, et al. [A patient of sensorimotor neuropathy with small cell lung carcinoma and anti-GM1 antibody]. Rinsho Shinkeigaku. 2002;42:878-80 pubmed
    ..She was treated with intravenous immunoglobulin, with transient improvement. The rare case of the paraneoplastic peripheral neuropathy with SCLC and anti-GM1 antibody was reported...
  33. Tschernatsch M, Singh P, Gross O, Gerriets T, Kneifel N, Probst C, et al. Anti-SOX1 antibodies in patients with paraneoplastic and non-paraneoplastic neuropathy. J Neuroimmunol. 2010;226:177-80 pubmed publisher
    ..Anti-SOX1 antibodies are associated with paraneoplastic neuropathies and may define another group of non-paraneoplastic, immune-mediated neuropathies...
  34. Tschernatsch M, Dierkes C, Gerriets T, Hosch J, Stolz E, Kaps M, et al. Paraneoplastic neurological syndromes in patients with carcinoid. Eur J Neurol. 2008;15:1390-4 pubmed publisher
    ..Few studies report the association of neurological syndromes with a carcinoid, the majority being a serotonin-related myopathy. We report four patients with a PNS associated with carcinoid...
  35. Ahlawat S, Chhabra A, Blakely J. Magnetic resonance neurography of peripheral nerve tumors and tumorlike conditions. Neuroimaging Clin N Am. 2014;24:171-92 pubmed publisher
    ..This article reviews the typical magnetic resonance neurography imaging appearances of neurogenic as well as nonneurogenic neoplasms and tumorlike lesions of peripheral nerves, with emphasis on distinguishing factors. ..
  36. Walcher J, Witter T, Rupprecht H. Hepatocellular carcinoma presenting with paraneoplastic demyelinating polyneuropathy and PR3-antineutrophil cytoplasmic antibody. J Clin Gastroenterol. 2002;35:364-5 pubmed
  37. Sá G, Correia C, Pires M, Lopes G. [Multiple paraneoplastic syndromes occurring in the same patient: clinical, imaging and neuro-pathological documentation]. Acta Med Port. 2006;19:489-93 pubmed
    ..This report also emphasises the importance of a diagnosis based on early clinical and imaging findings, given that, in most cases the cancer is not apparent...
  38. Gatti G, Simsek S, Kurne A, Zurrida S, Naninato P, Veronesi P, et al. Paraneoplastic neurological disorders in breast cancer. Breast. 2003;12:203-7 pubmed
    ..The aim of this paper is to briefly outline these paraneoplastic neurological syndromes and consider their relation to breast carcinoma...
  39. Kiylioglu N, Meydan N, Barutca S, Akyol A. Sub-acute sensory neuronopathy as a preceding sign of recurrence in colon carcinoma. Int J Gastrointest Cancer. 2003;34:135-7 pubmed
    ..We conclude that, in the case of subacute sensory neuronopathy without an obvious underlying etiological factor, an occult malignity should always be researched in clinical practice...
  40. Martin A, Messineo A, Lionetti P, Volta U, Stanghellini V, Barbara G, et al. A case of paraneoplastic inflammatory neuropathy of the gastrointestinal tract related to an underlying neuroblastoma: successful management with immunosuppressive therapy. J Pediatr Gastroenterol Nutr. 2008;46:457-60 pubmed publisher
  41. Pantalone D, Muscas G, Tings T, Paolucci R, Nincheri Kunz M, Borri A, et al. Peripheral paraneoplastic neuropathy, an uncommon clinical onset of sigmoid cancer. Case report and review of the literature. Tumori. 2002;88:347-9 pubmed
    ..In fact, these patients are usually first admitted and studied in a neurological unit, and the diagnosis of a tumor-associated disease is a delayed event...
  42. Prim N, Mennecier B, Behr C, Fraisse P, Echaniz Laguna A, Tranchant C, et al. [Small cell lung cancer and anti-Hu syndrome]. Rev Mal Respir. 2010;27:261-5 pubmed publisher
    ..The anti-Hu associated syndrome is a rare paraneoplastic neurological syndrome, which is principally associated with small-cell lung cancer...
  43. Sodhi M, Stoller J. Small cell carcinoma with paraneoplastic polyneuropathy and tumor embolization: a case report and literature review. Respiration. 2010;79:77-80 pubmed publisher
    ..To our knowledge, this patient represents only the second individual to be described with tumor embolization complicating small cell cancer and reminds clinicians of the extended spectrum of this disease...
  44. Bi W, Bannykh S, Martel M, Baehring J. Paraneoplastic subacute sensory neuronopathy secondary to a malignant mixed mullerian tumor. Obstet Gynecol. 2006;107:504-6 pubmed
    ..Paraneoplastic subacute sensory neuronopathy is a rapidly progressive autoimmune disorder commonly associated with small cell cancers. Relentless destruction of dorsal root ganglion cells by cytotoxic T cells leads to a poor prognosis...
  45. Yilmaz M, Okan V, Pehlivan M, Ozkur A, Pehlivan Y, Buyukhatipoglu H, et al. A case report of POEMS syndrome developing during the clinical course of immune thrombocytopenic purpura. Platelets. 2007;18:540-2 pubmed
    ..To our knowledge, this is the first description of coexistent ITP and POEMS syndrome in the literature...
  46. Schilstra A, van Tuijl J, van Suylen R, Faber C, ten Velde G. Unclassified rhabdomyosarcoma in a patient with anti-Hu syndrome. Acta Clin Belg. 2005;60:248-51 pubmed
    ..In this case report we present a patient with the anti-Hu syndrome associated with an unclassified rhabdomyosarcoma with epitheloid cellular morphology and neuroendocrine differentiation...
  47. Leypoldt F, Friese M, Bohm J, Bäumer T. Multiple enlarged nerves on neurosonography: an unusual paraneoplastic case. Muscle Nerve. 2011;43:756-8 pubmed publisher
    ..It emphasizes the role of nerve ultrasound in the diagnostic work-up of peripheral nervous system disorders...
  48. Miyazaki Y, Kagamihara Y, Nakayama H, Mochizuki Y, Arai N, Miyamoto K, et al. [Paraneoplastic neuropathy with respiratory failure preceded by depression]. No To Shinkei. 2002;54:83-90 pubmed
  49. Suzuki M, Kimura H, Tachibana I, Fujimura H, Nakatsuji Y, Sugai F, et al. Improvement of anti-Hu-associated paraneoplastic sensory neuropathy after chemoradiotherapy in a small cell lung cancer patient. Intern Med. 2001;40:1140-3 pubmed
    ..A complete response was achieved through chemotherapy (carboplatin and etoposide) and subsequent radiation therapy. Notably, his neurological conditions, although not changed during the hospitalization, gradually improved afterwards...
  50. Kato T. [Neurological symptoms as the initial signs of malignant tumors: paraneoplastic neuropathies]. Nihon Naika Gakkai Zasshi. 2003;92:1801-8 pubmed
  51. Block M, Vassallo R. Lack of FDG uptake in small cell carcinoma associated with ANNA-1 positive paraneoplastic autonomic neuropathy. J Thorac Oncol. 2008;3:542-4 pubmed publisher
  52. Auf G, Chen L, Fornes P, Le Clanche C, Delattre J, Carpentier A. CpG-oligodeoxynucleotide rejection of a neuroblastoma in A/J mice does not induce a paraneoplastic disease. Neurosci Lett. 2002;327:189-92 pubmed
    ..None of the animals developed neurological disabilities and histological studies of the nervous system were normal. CpG-ODN can therefore trigger neuroblastoma rejection without inducing neurological paraneoplastic disease...
  53. Antoine J, Honnorat J, Camdessanche J, Magistris M, Absi L, Mosnier J, et al. Paraneoplastic anti-CV2 antibodies react with peripheral nerve and are associated with a mixed axonal and demyelinating peripheral neuropathy. Ann Neurol. 2001;49:214-21 pubmed