Paraneoplastic neuropathies

What are paraneoplastic neuropathies?

The most common paraneoplastic neuropathy is distal sensorimotor axonal neuropathy indistinguishable from an idiopathic, nonparaneoplastic neuropathy with the same features.

A sensory ganglionopathy or neuronopathy, which presents with severe sensory loss with marked sensory ataxia with minimal weakness, is also a paraneoplastic condition that accounts for 20% of cases of sensory ganglionopathies (the remainder being largely idiopathic or associated with Sjögren’s syndrome).

Subacute autonomic (widespread or limited) neuropathy and vasculitic neuropathy may also represent a paraneoplastic disorder.

Lastly, the paraproteinemia-associated sensorimotor neuropathies such as POEMS are paraneoplastic. 

Sources

Kaku M, Simpson DM: HIV neuropathy. Curr Opin HIV AIDS 9:521–526, 2014. 

Berger AR, Scaumburg HH: Human toxic neuropathy caused by industrial agents. In Dyck PJ, Thomas PK (eds): Peripheral Neuropathy, 4th ed. Philadelphia, WB Saunders, 2005, pp 2505-2525. 

Paraneoplastic neuropathies may occur in isolation or as part of a more generalized paraneoplastic neurologic syndrome (e.g., with limbic encephalitis and ataxia). The most common associated antibodies are anti-Hu (ANNA-1) and anti-CV2 (CRMP-5), with less common antibodies including amphiphysin, anti-Ri (ANNA-2), ANNA-3, and N-type calcium channel antibodies. Small-cell lung cancer tends to be the most common tumor associated with these syndromes, but many tumors are potential culprits.

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