Paraneoplastic neurological syndromes: literature review and clinical case of multifocal cranial neuropathy of paraneoplastic origin

February 3, 2023
1079
Resume

A study of the scientific literature was conducted using the Internet, MEDLINE, PubMed, Medscape regarding paraneoplastic neurological syndrome, focusing on the clinical manifestations of its classical and atypical forms. The recommendations of the European Federation of Neurological Societies regarding tumor screening in paraneoplastic neurological syndrome are noted. A clinical case of multifocal neuropathy of cranial nerves as a manifestation of paraneoplastic syndrome is given. The course of the disease, clinical symptoms, diagnostic measures and treatment tactics are described in detail. The need for a timely detailed examination and timely initiation of treatment of patients in case of cranial nerve neuropathy of unknown origin is shown.

References

  1. Graus F., Delattre J.Y., Antoine J.C. et al. (2004) Recommended diagnostic criteria for paraneoplastic neurological syndromes. J. Neurol. Neurosurg. Psychiatr., 75(8): 1135–1140. doi: 10.1136/jnnp.2003.034447.
  2. Dalmau J., Lancaster E., Martinez-Hernandez E. et al. (2011) Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis. Lancet Neurol., 10(1): 63–74. doi: 10.1016/S1474-4422(10)70253-2.
  3. Graus F., Dalmau J. (2012) Paraneoplastic neurological syndromes. Curr. Opin. Neurol. 25(6): 795–801. doi: 10.1097/WCO.0b013e328359da15.
  4. Giometto B., Grisold W., Vitaliani R. et al.; PNS Euronetwork (2010) Paraneoplastic neurologic syndrome in the PNS Euronetwork database: a European study from 20 centers. Arch. Neurol., 67(3): 330–335. doi: 10.1001/archneurol.2009.341.
  5. Ducray F., Graus F., Vigliani M.C. et al. (2010) Delayed onset of a second paraneoplastic neurological syndrome in eight patients. J. Neurol. Neurosurg. Psychiatr., 81(8): 937–939. doi: 10.1136/jnnp.2009.190199.
  6. Titulaer M.J., Soffietti R., Dalmau J. et al.; European Federation of Neurological Societies (2011) Screening for tumours in paraneoplastic syndromes: report of an EFNS task force. Eur. J. Neurol., 18(1): 19–e3. doi: 10.1111/j.1468-1331.2010.03220.x.
  7. Posner J.B. (1995) Neurologic complications of cancer. Philadelphia, FA Davis Company, 353–384. doi.org/10.1002/ana.410390226.
  8. Graus F., Keime-Guibert F., Reñé R. et al. (2001) Anti-Hu-associated paraneoplastic encephalomyelitis: analysis of 200 patients. Brain, 124: 1138–1148. DOI: 10.1093/brain/124.6.1138.
  9. Graus F., Vogrig A., Muñiz-Castrillo S. et al. (2021) Updated Diagnostic Criteria for Paraneoplastic Neurologic Syndromes. Neurol. Neuroimmunol. Neuroinflamm., 8(4): e1014. DOI: 10.1212/NXI.0000000000001014.
  10. Henson R.A., Urich H. (1982) Part III. Paraneoplastic disorders. In: Henson R.A., Urich H., (Eds.) Cancer and the nervous system. Oxford: Blackwell Scientific Publications, 311–451.
  11. Gultekin S.H., Rosenfeld M.R., Voltz R. et al. (2000) Paraneoplastic limbic encephalitis: neurological symptoms, immunological findings and tumour association in 50 patients. Brain, 123 (Pt 7): 1481–1494. doi: 10.1093/brain/123.7.1481.
  12. Vincent A., Buckley C., Schott J.M. et al. (2004) Potassium channel antibody-associated encephalopathy: a potentially immunotherapy-responsive form of limbic encephalitis. Brain, 127(Pt 3): 701–712. doi: 10.1093/brain/awh077.
  13. Pozo-Rosich P., Clover L., Saiz A. et al. (2003) Voltage-gated potassium channel antibodies in limbic encephalitis. Ann. Neurol., 54: 530–533. DOI: 10.1002/ana.10713.
  14. Mason W.P., Graus F., Lang B. et al. (1997) Small-cell lung cancer, paraneoplastic cerebellar degeneration and the Lambert-Eaton mysthenic syndrome. Brain, 120: 1279–1300. doi: 10.1093/brain/120.8.1279.
  15. Horwich M.S., Cho L., Porro R.S. et al. (1977) Subacute sensory neuropathy: a remote effect of carcinoma. Ann. Neurol., 2: 7–19.
  16. Chalk C.H., Windebank A.J., Kimmel D.W. et al. (1992) The distinctive clinical features of paraneoplastic sensory neuronopathy. Can. J. Neurol. Sci., 19: 346–351.
  17. Binks S., Uy C., Honnorat J. et al. (2022) Paraneoplastic neurological syndromes: a practical approach to diagnosis and management. Pract. Neurol., 22: 19–31. doi: 10.1136/practneurol-2021-003073.
  18. Graus F., Elkon K.B., Lloberes P. et al. (1987) Neuronal antinuclear antibody (anti-Hu) in paraneoplastic encephalomyelitis simulating acute polyneuritis. Acta Neurol. Scand., 75(4): 249–252. doi: 10.1111/j.1600-0404.1987.tb07928.x.
  19. Antoine J.C., Mosnier J.F., Honnorat J. et al. (1998) Paraneoplastic demyelinating neuropathy, subacute sensory neuropathy, and anti-Hu antibodies: clinicopathological study of an autopsy case. Muscle Nerve, 21: 850–857.
  20. Camdessanché J.P., Antoine J.C., Honnorat J. et al. (2002) Paraneoplastic peripheral neuropathy associated with anti-Hu antibodies. A clinical and electrophysiological study of 20 patients. Brain, 125: 166–175. doi: 10.1093/brain/awf006.
  21. Martin A.C., Friedlander M., Kiernan M.C. (2006) Paraneoplastic mononeuritis multiplex in non-small-cell lung carcinoma. J. Clin. Neurosci., http://dx.doi.org/10.1016/j.jocn.2005.06.006.
  22. Rajabally Y.A., Qaddoura B., Abbott R.J. (2008) Steroid-responsive paraneoplastic demyelinating neuropathy and myelopathy associated with breast carcinoma. J. Clin. Neuromuscul. Dis., DOI: 10.1097/CND.0b013e31818e952b.
  23. Leypoldt F., Friese M.A., Böhm J., Bäumer T. (2011) Multiple enlarged nerves on neurosonography: an unusual paraneoplastic case. Muscle Nerve, 43(5): 756–758. doi: 10.1002/mus.22010.