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The Distinctive Clinical Features of Paraneoplastic Sensory Neuronopathy

Published online by Cambridge University Press:  18 September 2015

Colin H. Chalk ,
Anthony J. Windebank ,
David W. Kimmel  and
Philip G. McManis
Colin H. Chalk
Affiliation:
Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
Anthony J. Windebank*
Affiliation:
Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
David W. Kimmel
Affiliation:
Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
Philip G. McManis
Affiliation:
Department of Neurology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota
*
Mayo Clinic, 1501 Guggenheim Building, 200 First Street SW, Rochester, Minnesota 55905, U.S.A.
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Abstract:

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A 15-year experience with paraneoplastic sensory neuronopathy at the Mayo Clinic is reviewed. Of 26 patients with paraneoplastic sensory neuronopathy, 19 had small cell lung cancer, 4 had breast cancer, and 3 had other neoplasms. There was a striking predominance of females (20:6). Neuropathic symptoms (pain, paresthesia, sensory loss) were asymmetric at onset, with a predilection for the upper limbs; in three patients, symptoms were confined to the arms. Electrophysiologic testing revealed absent sensory responses and normal or minimally altered motor responses. Slightly more than half the patients had associated autonomic, cerebellar, or cerebral abnormalities. In some patients, treatment of the neoplasm seemed to halt progression of the neuronopathy, but none had neurologic improvement and most continued to worsen, even when the oncologic response was good. Distinguishing between paraneoplastic and nonparaneoplastic sensory neuronopathies can be difficult, but prominent neuropathic pain, neurologic dysfunction involving more than the peripheral sensory system, or an increased cerebrospinal fluid protein value should prompt a careful search for a cancer.

Type
Articles
Information
Canadian Journal of Neurological Sciences , Volume 19 , Issue 3 , August 1992 , pp. 346 - 351
Copyright
Copyright © Canadian Neurological Sciences Federation 1992

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