| Abstract: |
This chapter discusses paraneoplastic syndromes affecting the nervous system that are rare but devastating complications of systemic cancer. The neurological disorder usually precedes identification of the cancer and can affect any portion of the nervous system, including brain, spinal cord, peripheral nerves, and muscle. A single area or cell type of the nervous system may be affected, or the entire neuraxis may be involved. The pathogenesis of paraneoplastic syndromes involving the nervous system is thought to be immune mediated: the current hypothesis is that antigens usually expressed only in neurons are expressed in a cancer; the immune system recognizes the antigen in the cancer as foreign and mounts an immune response that slows the growth of the tumor but damages the nervous system. The diagnosis of a paraneoplastic syndrome is made either by identifying a small cancer in a patient with a neurological disorder or by identifying paraneoplastic autoantibodies in the serum of patients. The treatment involves identification and treatment of the causal cancer and immunosuppression to suppress both the humoral and cellular immune response. © 2003 Elsevier Inc. All rights reserved. |
