Paraneoplastic Syndrome
Original Editors - Brittany Chorley & Seth Chorley from Bellarmine University's Pathophysiology of Complex Patient Problems project.
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Definition/Description[edit | edit source]
Paraneoplastic syndrome is a group of rare disorders that are triggered by an abnormal immune system response a neoplasm. It is hypothesisized that Paraneoplastic syndrome occurs when cancer-fighting antibodies or white blood cells (known as T cells) mistakenly attack normal cells in the nervous system. Neurologic symptoms can develop over a period of days to weeks and usually occur prior to the tumor being discovered.
Prevalence[edit | edit source]
You will see symptoms of this disorder typically in the middle-aged to older population. Specifically, it is most common in individuals with lung, ovarian, lymphatic, or breast cancer.
Characteristics/Clinical Presentation[edit | edit source]
Paraneoplastic syndrome presents with symptoms that include difficulty in 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, and vertigo or dizziness. Paraneoplastic syndromes include Lambert-Eaton myasthenic syndrome, stiff-person syndrome, encephalomyelitis, myasthenia gravis, cerebellar degeneration, limbic or brainstem encephalitis, neuromyotonia, opsoclonus, and sensory neuropathy.
Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
Medications will depend on what type of paraneoplastic syndrome the patient has. In addition to chemotherapy for the underlying cancer, medications could include:
Corticosteroids, such as prednisone, inhibit inflammation. Long-term use of corticosteroids may cause weakening of the bones (osteoporosis), diabetes, high blood pressure, high cholesterol and other serious side effects.
Immunosuppressants inhibit the production of disease-fighting white blood cells. Side effects include an increased risk of infections. Drugs with immunosuppressant properties that may be used include azathioprine (Imuran) and cyclophosphamide (Cytoxan).
Anti-seizure medications may help control seizures associated with syndromes affecting nerve cells in the brain. A number of anti-seizure medications are available, including carbamazepine (Tegretol, Carbatrol, others) and valproic acid (Depakene, Stavzor).
Medications to enhance nerve to muscle transmission may improve symptoms of syndromes affecting muscle function. Some drugs, such as 3,4-diaminopyridine, enhance the release of a chemical messenger that transmits a signal from nerve cells to muscles. Other drugs, such as pyridostigmine (Mestinon, Regonol), prevent the breakdown of these chemical messengers.
Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
Abdominal Aortic Aneurysm
Anemia
Antithrombin Deficiency
Attention Deficit Hyperactivity Disorder
Bone Marrow Failure
Chronic Fatigue Syndrome
Dermatomyositis
Diabetes Mellitus, Type 1
Glomerulonephritis, Acute
Mixed Connective-Tissue Disease
Myelodysplastic Syndrome
Nephrotic Syndrome
Personality Disorders
Polycythemia Vera
Polymyalgia Rheumatica
Scleroderma
Superficial Thrombophlebitis
Systemic Lupus Erythematosus
Undifferentiated Connective-Tissue Disease
Case Reports/ Case Studies[edit | edit source]
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Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
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