Paraneoplastic Syndrome

Paraneoplastic Neurological Syndromes are a group of disorders that begin to exhibit symptoms as results of a cancer tumor called a “neoplasm.” Often these issues are related to an immune response the body has because of these tumors.

It is theorized that the antibodies or the presence of white blood cells may trigger the changes or problems that are seen. Some neoplasms have the ability to secrete hormones or other proteins that results in changes in symptoms.

These syndromes are often seen in middle-aged or older adults. They more commonly occur in people with Lung Cancer, ovarian, lymphatic, or breast cancer. Overall, these are rare conditions.

The interesting aspect is that these symptoms often start even before the tumor, or cancer-filled growth, is found. They slowly develop over a few days or weeks.

Symptoms include:

  –  Difficulty walking or swallowing
–  Loss of muscle tone
–  Loss of fine motor coordination
–  Slurred speech
–  Memory loss
–  Vision problems
–  Sleep disturbances
–  Dementia
–  Seizures
–  Sensory loss in the limbs
–  Vertigo or dizziness

Paraneoplastic syndromes include:

1.)  Lambert-Eaton Myasthenic Syndrome
2.)  Stiff-Person Syndrome
3.)  Encephalomyelitis
4.)  Myasthenia Gravis
5.)  Cerebellar Degeneration
6.)  Limbic or Brainstem Encephalitis
7.)  Neuromyotonia
8.)  Opsoclonus

Symptoms may be related to Endocrine Disorders. This can occur in up to 20% of lung cancers.

Diagnosis

Often the process of diagnosis is to determine initial cause. This may be a difficult process as some of the symptoms could correlate to other medical problems.

The diagnosis of cancer is important process in the treatment process.

Staging of the cancer during the diagnosis process will help determine the potential outcomes from paraneoplastic syndromes.

Treatment

Treatment first addresses the presence of any neoplasms, then treatment shifts to attempts to decrease the autoimmune response.

1.)  Plasmapheresis

–  This is a process that cleanses antibodies from the blood.

2.)  Speech and physical therapy may help individuals regain some functions.

There is no cure for paraneoplastic syndromes, and treatment will not stop neurological damage.

–  Paraneoplastic neurological syndromes in the era of immune-checkpoint inhibitors  –  https://www.nature.com/articles/s41571-019-0194-4