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Paraneoplastic Syndromes of the Nervous System

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Overview

Paraneoplastic syndromes of the nervous system are a rare group of conditions that develop in some individuals with cancer. These syndromes occur when the immune system, in its attempt to fight cancer, inadvertently attacks normal cells within the nervous system. Although uncommon, they can significantly impact a patient’s quality of life and require careful evaluation and management.

Types of Paraneoplastic Syndromes of the Nervous System

  1. Paraneoplastic Encephalitis: Inflammation of the brain caused by an immune response to cancer.
  2. Paraneoplastic Cerebellar Degeneration: Affects the cerebellum, leading to coordination and balance problems.
  3. Limbic Encephalitis: Involves the limbic system, causing memory loss, mood changes, and seizures.
  4. Stiff Person Syndrome: Characterized by muscle stiffness and spasms due to antibodies attacking nerve cells.
  5. Opsoclonus-Myoclonus Syndrome: Results in rapid, involuntary eye movements and muscle jerks.

Causes of Paraneoplastic Syndromes of the Nervous System

  • Immune Response: Paraneoplastic syndromes are triggered by cancer-fighting antibodies or T cells mistakenly attacking normal nervous system cells.
  • Tumor-Produced Substances: Some cancers produce hormones or cytokines that affect nerve function.

Risk Factors of Paraneoplastic Syndromes of the Nervous System

  • Cancer Diagnosis: Paraneoplastic syndromes often precede cancer diagnosis.
  • Certain Tumor Types: Lung, breast, ovarian, and lymphoma cancers are commonly associated.

Symptoms of Paraneoplastic Syndromes of the Nervous System

1. Neurological Symptoms: Weakness, sensory loss, and reduced reflexes (polyneuropathy). Cerebellar dysfunction (loss of coordination, tremors). Encephalitis (memory loss, cognitive impairment). Uncontrollable eye movements (opsoclonus). Weakness, sensory loss, and reduced reflexes (polyneuropathy). Cerebellar dysfunction (loss of coordination, tremors). Encephalitis (memory loss, cognitive impairment). Uncontrollable eye movements (opsoclonus).
2. General Symptoms: Fever, night sweats, weight loss, and decreased appetite.

Preventions of Paraneoplastic Syndromes of the Nervous System

  • Early Detection: Prompt cancer diagnosis can prevent complications.
  • No Specific Preventive Measures: Currently, no specific strategies exist to prevent paraneoplastic syndromes.

Diagnosis of Paraneoplastic Syndromes of the Nervous System

  1. Physical Exam: Assess neurological symptoms.
  2. Blood Tests: Look for paraneoplastic antibodies.
  3. Imaging: MRI or CT scans to visualize nervous system abnormalities.
  4. Electrophysiology: Measures nerve and muscle function.
  5. Antibody Testing: Identifies specific antibodies associated with paraneoplastic syndromes.

Treatment for Paraneoplastic Syndromes of the Nervous System

  • Address Underlying Cancer: Treat the primary tumor.
  • Immunosuppression: Medications like prednisone or azathioprine.
  • Symptomatic Relief: Manage specific symptoms (e.g., antiepileptic drugs for seizures).
  • Physical and Occupational Therapy: Improve function and quality of life.

When to seek medical attention ?

If you experience unexplained neurological symptoms, especially if you have a history of cancer.