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Paraneoplastic Polyneuropathy

Peripheral Neuropathy Carcinomatous


Presentation

  • A bronchogenic ("oat cell") carcinoma was present in the first patient, who had an almost exclusively motor neuropathy. An osteosarcoma was diagnosed in the second case, and its association with a polyneuropathy seems to be exceptional.[ncbi.nlm.nih.gov]
  • We present a patient with anti-Hu antibody-associated paraneoplastic sensory polyneuropathy and tumor embolism diagnosed by endovascular biopsy to be due to small cell cancer, the primary site of which was not evident.[ncbi.nlm.nih.gov]
  • It may be the initial presentation of an occult neoplasm. Detection and resection of the neoplasm may result in cure.[tititudorancea.com]
  • Case Report: We report the case of a 15-year-old male patient who presented with a 4 weeks history of progressive gait instability and neuropathic pain on excertion.[thieme-connect.com]
  • The most common clinical presentation is a symmetric distal mixed sensorimotor polyneuropathy.[profiles.umassmed.edu]
Progressive Polyneuropathy
  • The patient received two courses of intravenous immunoglobulin (0.6 g/kg/d) 6 and 8 weeks after symptoms onset without any significant clinical change and continuing progressive polyneuropathy.[thieme-connect.com]
Pathologist
  • He is also now Associate Pathologist (Neuropathology) at St. Michael’s Hospital, Toronto. Dr. Bilbo is a past Chief Examiner, Section of Neuropathology, for the Royal College of Physicians and Surgeons of Canada.[books.google.com]
Anorexia
  • Paraneoplastic syndromes GI tract, eg anorexia, vomiting, protein-losing enteropathy, liver disease Hematologic, eg leukemoid reaction, reactive eosinophilia, peripheral 'cytoses or 'cytopenias, hemolysis, DIC, thromboembolism, thrombophlebitis migrans[medical-dictionary.thefreedictionary.com]
Vomiting
  • Paraneoplastic syndromes GI tract, eg anorexia, vomiting, protein-losing enteropathy, liver disease Hematologic, eg leukemoid reaction, reactive eosinophilia, peripheral 'cytoses or 'cytopenias, hemolysis, DIC, thromboembolism, thrombophlebitis migrans[medical-dictionary.thefreedictionary.com]
  • […] dysfunction: frequency, excessive urinating at night, urgency, stress incontinence, retention, hesitancy Sexual dysfunction: erectile dysfunction, vaginal dryness, decreased libido Gastrointestinal dysfunction: intermittent diarrhea, constipation, nausea, vomiting[my.clevelandclinic.org]
Loss of Appetite
  • […] night, urgency, stress incontinence, retention, hesitancy Sexual dysfunction: erectile dysfunction, vaginal dryness, decreased libido Gastrointestinal dysfunction: intermittent diarrhea, constipation, nausea, vomiting, full-ness after eating little, loss[my.clevelandclinic.org]
Pruritus
  • Pruritus. Dry skin. Pale, cold feet. Worsening of symptoms at night. Examination There may be features on general examination which point to a specific disease.[patient.info]
Blister
  • Kidney diseases (code 593.9) Glomerular diseases and nephrotic syndrome (code 581.9) Dermatomyositis (code 710.3) and other inflammatory muscle disorders (code 728.9) Skin disorders (code 709.9), including Pemphigus (code 694.4), a skin disorder with blisters[hcpro.com]
Myopathy
  • […] cytoses or 'cytopenias, hemolysis, DIC, thromboembolism, thrombophlebitis migrans Hormonal effects Metabolic disease, eg lactic acidosis, hypertrophic pulmonary osteoarthropathy, hyperamylasemia, hyperlipidemia Neuromuscular, eg peripheral neuropathy, myopathy[medical-dictionary.thefreedictionary.com]
  • Neoplasm: Waldenström's macroglobulinemia Rippling muscle syndrome Neoplasm: Thymoma Scleromyxedema Skin papules; Myopathy; Raynaud's Neoplasm: IgG or IgA λ M-protein Amyloid myopathy Metabolic/Hormonal Corticosteroid myopathy Ectopic ACTH production[neuromuscular.wustl.edu]
  • Ross reported that the most frequent neurological complications were mixed peripheral neuropathy, myopathy, or a mixed syndrome, and described a central distribution myopathy, with symmetrical muscle wasting ( 6 ).[jtd.amegroups.com]
  • Loss of weight and cachexia may suggest the presence of a neoplasm, or be a cause of myopathy. For any patient, if paraneoplastic neuropathy is suspected, the priority is to demonstrate the presence of a tumour.[jnnp.bmj.com]
  • Dyck PJ, Bailey AA, Olszewski J: Carcinomatous neuromyopathy: a case of sensory neuropathy and myopathy with onset three and one-half years before clinical recognition of bronchogenic carcinoma.[link.springer.com]
Musculoskeletal Pain
  • The fourth section provides in-depth coverage of specific painful conditions—neuropathic pain syndromes, psychological contributions to pain, vascular, cutaneous, and musculoskeletal pains, pain due to cancer, acute pain, pain in special populations,[books.google.com]
Polyneuropathy
  • Three of 8,954 in- patients have been selected as affected by paraneoplastic polyneuropathy.[ncbi.nlm.nih.gov]
  • […] is: 1 Images & Illustrations of paraneoplastic polyneuropathy Translation Find a translation for the paraneoplastic polyneuropathy definition in other languages: Discuss these paraneoplastic polyneuropathy definitions with the community: Word of the[definitions.net]
  • The most common clinical presentation is a symmetric distal mixed sensorimotor polyneuropathy.[profiles.umassmed.edu]
  • We present a patient with anti-Hu antibody-associated paraneoplastic sensory polyneuropathy and tumor embolism diagnosed by endovascular biopsy to be due to small cell cancer, the primary site of which was not evident.[ncbi.nlm.nih.gov]
  • This case report describes for the first time a therapy refractory clinical course of a paraneoplastic sensorimotor polyneuropathy associated with isolated cerebral sarcoma.[thieme-connect.com]
Peripheral Neuropathy
  • Features of Textbook of Peripheral Neuropathy Include : ̈ Practical yet comprehensiveóan accessible ìgo-toî reference for clinicians ̈ Covers all clinically relevant peripheral neuropathies ̈ Clinical Pearls and Key Points are set off from the text for[books.google.com]
  • (NCI Thesaurus) Definition 2 A diffuse or multifocal peripheral neuropathy related to the remote effects of a neoplasm, most often carcinoma or lymphoma. Pathologically, there are inflammatory changes in peripheral nerves.[tititudorancea.com]
  • A diffuse or multifocal peripheral neuropathy related to the remote effects of a neoplasm, most often carcinoma or lymphoma. Pathologically, there are inflammatory changes in peripheral nerves.[profiles.umassmed.edu]
  • National Library of Medicine (0.00 / 0 votes) Rate this definition: Paraneoplastic Polyneuropathy A diffuse or multifocal peripheral neuropathy related to the remote effects of a neoplasm, most often carcinoma or lymphoma.[definitions.net]
  • Abstract A patient with painful peripheral neuropathy is presented, whose symptoms were thought to result from an infection with Borrelia burgdorferi sensu lato.[prohealth.com]
Asthenia
  • Asthenia” was reported in a patient with bronchopulmonary carcinoid related Cushing’s syndrome ( 11 ) and complete resolution of the Cushing’s syndrome was reported after surgical resection of bronchopulmonary carcinoids ( 11, 14 ).[jtd.amegroups.com]
  • Similar to amitriptyline but less sedating Imipramine 10-300 mg Similar to amitriptyline but less sedating Desipramine 10-300 mg Similar to amitriptyline but least sedating Duloxetine 60-120 mg Nausea, dry mouth, constipation Venlafaxine XR 37.5-225 mg Asthenia[clevelandclinicmeded.com]
Neuralgia
  • Neuropathy (nerve damage), peripheral, idiopathic Neuropathy, hereditary Neuropathy, peripheral Neuropathy, peripheral, idiopathic Paraneoplastic peripheral neuropathy (disorder) Paraneoplastic polyneuropathy (disorder) Peripheral nerve disease Peripheral neuralgia[icd9data.com]
  • Medicines used to treat this condition: Over-the-counter and prescription pain relievers to reduce stabbing pain ( neuralgia ) Anticonvulsants or antidepressants Lotions, creams, or medicated patches Use pain medicine only when necessary.[medlineplus.gov]
Hypesthesia
  • Sensory symptoms include tingling or paresthesias, increased sensation in affected areas (hypesthesia), and numbness or reduced sensation.[aafp.org]

Workup

  • Further workup revealed mediastinal Hodgkin’s disease (HD; nodular sclerosing subtype) Ann Arbor stage II and non-small cell cancer of the lung (stage T1N0M0).[prohealth.com]
  • As the patient continued to loose weight and appetite, his workup was repeated.[ispub.com]
  • Complete electrodiagnostic studies [Nerve conduction studies (NCS) and needle electromyography (EMG)]: Perform if unclear after initial workup or presence of atypical symptoms: asymmetry, motor predominance, non-length dependence, prominent autonomic[clinicaladvisor.com]
Cytopenia
  • Paraneoplastic syndromes GI tract, eg anorexia, vomiting, protein-losing enteropathy, liver disease Hematologic, eg leukemoid reaction, reactive eosinophilia, peripheral 'cytoses or 'cytopenias, hemolysis, DIC, thromboembolism, thrombophlebitis migrans[medical-dictionary.thefreedictionary.com]
Borrelia Burgdorferi
  • Abstract A patient with painful peripheral neuropathy is presented, whose symptoms were thought to result from an infection with Borrelia burgdorferi sensu lato.[prohealth.com]
  • burgdorferi antibodies (total, IgG, IgM) Herpes zoster Varicella zoster antigen, antibodies (IgG, IgM), and DNA Cytomegalovirus CMV antibodies (IgG, IgM) and DNA Hepatitis B HBs antigen, HBc antibodies (IgG, IgM) Hepatitis C Hepatitis C antibody and[questdiagnostics.com]
Nerve Biopsy showing Axonal Neuropathy
  • Electrophysiologic studies and sural nerve biopsy showed axonal neuropathy consistent with a paraneoplastic syndrome.[prohealth.com]
Nerve Biopsy showing Axonal Neuropathy
  • Electrophysiologic studies and sural nerve biopsy showed axonal neuropathy consistent with a paraneoplastic syndrome.[prohealth.com]

Treatment

  • Investigations of the cerebrospinal fluid for signs of inflammation and borrelial antibodies were negative, and the patient did not benefit from repeated antibiotic treatment.[prohealth.com]
  • Pathogenesis also varies from direct infiltration by cancer cells, to treatment toxicity, to metabolic derangement, cachexia, infections and paraneoplastic syndromes.[thieme-connect.com]
  • The textbookprovides an evidence-based approach to testing, differential diagnosis, and treatment, and should serveas a trusted resource for healthcare professionals confronting the many manifestations of peripheralneuropathy in clinical practice.[books.google.com]
  • The book concludes with discussions of the provision of pain treatment in a variety of clinical settings, including pain clinics, spine clinics, the primary care setting, the emergency department, the intensive care unit, and end-of-life care.[books.google.com]
  • […] biologic' effects of malignancy, which may be the first sign of a neoplasm or its recurrence; PSs occur in 15% of CAs, are caused by hormones, growth factors, biological response modifiers, and other as-yet unidentified factors, and may regress with treatment[medical-dictionary.thefreedictionary.com]

Prognosis

  • ), 疲労(fatigue) Keyword: 傍腫瘍性神経症侯群(paraneoplastic syndrome), 後根神経節(dorsal root ganglion), 感覚性運動失調(sensory ataxia), 長期予後(long-term prognosis), 疲労(fatigue) pp.572-576 発行日 2009年9月18日 Published Date 2009/9/18 Abstract 文献概要 1ページ目 Look Inside 参考文献 Reference[webview.isho.jp]
  • Prognosis The prognosis is determined by the particular cause of the autonomic neuropathy. In most cases the course is one of gradual progression. In the case of diabetes mellitus the prognosis is improved with good control of diabetes.[patient.info]
  • Prognosis The prognosis for persons with paraneoplastic syndromes depends on the specific type of PS, and the progression of the underlying cancer.[encyclopedia.com]
  • 66%; Occasional changes in cortex, brainstem or cauda equina Ma syndromes: Brainstem & Cerebellar disorders Age: 58 to 63 years Clinical: Not uniform Cerebellar: trunk & extremities Brainstem: EOM limitation; Dysphagia Other: Sensory loss; Myokymia Prognosis[neuromuscular.wustl.edu]
  • Croft PB, Wilkinson M: The course and prognosis in some types of carcinomatous neuromyopathy. Brain 92: 1–8, 1969 PubMed Google Scholar 11. Wilkinson PC: Serological findings in carcinomatous neuromyopathy.[link.springer.com]

Etiology

  • Applicable To Carcinomatous neuromyopathy Sensorial paraneoplastic neuropathy [Denny Brown] Code First Code First Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10data.com]
  • Tabs Content Clinical Overview Indications for Testing Autoantibody testing might be considered in individuals presenting with severe or rapidly progressive muscle weakness and sensory symptoms and no known underlying infection or etiology.[arupconsult.com]
  • […] with extreme symptoms, they may present with burning pain, muscle wasting, paralysis, or organ dysfunction. 1 There are multiple causes of peripheral neuropathy, and in the cancer patient, identifying the culprit may be complicated by a plethora of etiologies[practicalpainmanagement.com]
  • Questions exploring different potential etiology’s as well to discriminate between syndromes: Etiologic questions Duration of symptoms (acute versus sub-acute syndromes).[clinicaladvisor.com]
  • With a systematic approach to the evaluation of these disorders, approximately 75% of patients have a specific etiologic diagnosis.[clevelandclinicmeded.com]

Epidemiology

  • Epidemiology In general, these can occur in men and women at any age, but the epidemiology will depend on the particular cause. Some causes are very rare.[patient.info]
  • Plasma exchange Ataxia with antibodies to CARP 8 10 Epidemiology: 1 patient; 77 year old female Clinical: Pure cerebellar syndrome Onset: 3 years after neoplasm Ataxia: Limb; Truncal; Gait; Dysarthria Ocular: Horizontal nystagmus Mental status: Normal[neuromuscular.wustl.edu]
  • In a previous large scale epidemiological study (United States-based databases, 1973-1991, 8,305 cases) metastases were evident at diagnosis in 45% of patients, and the overall 5-year survival was 50% ( 5 ).[jtd.amegroups.com]
  • Guillain-Barré syndrome: epidemiology, diagnosis and treatment. In, Neuroimmunological Diseases (ed. by Kusunoki S), Springer Japan, Tokyo, pp153-164, 2016. Kusunoki S. Preface.[med.kindai.ac.jp]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology As might be expected, various pathophysiological processes are involved depending on the particular cause. [ 3 ] Although loss of somatic C fibres is associated with autonomic deficits, there is now known to be a more selective involvement[patient.info]
  • Pathophysiology Although peripheral neuropathy has multiple etiologies, the nerve has a limited number of ways to respond to injury. 4, 5 The damage can occur at the level of the axon (i.e., axonopathy).[aafp.org]
  • Back to Top Pathophysiology and Natural History Despite the diverse array of medical disorders that cause peripheral neuropathies, peripheral nerves exhibit only a few distinct pathologic reactions to an insult or disease: wallerian degeneration, axonal[clevelandclinicmeded.com]
  • A case of finger clubbing associated with nasopharyngeal carcinoma in a young girl, and review of pathophysiology. J Pak Med Assoc 2009; 59(4): 253-4. [ PubMed ] 29. Garganese MC, et al.[medical.nikkeibp.co.jp]

Prevention

  • Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. ‎[books.google.es]
  • This review looks at the common causes of neuropathy in cancer patients, as well as effective therapies—and even preventions. Page 1 of 6 Neuropathic pain is often defined as pain caused by a lesion or disease of the somatosensory nervous system.[practicalpainmanagement.com]
  • Prevention of presynaptic acetylcholine release (botulism). Accumulation of toxic metabolites (for example, in liver disease). Postganglionic abnormalities (connective tissue diseases, systemic lupus erythematosus (SLE), rheumatoid arthritis).[patient.info]
  • For long-term rehabilitation management in these two cases, we suggested a regular exercise program to prevent muscle weakness. Copyright 2009, The Japanese Association of Rehabilitation Medicine. All rights reserved.[webview.isho.jp]
  • In patients with severe sensory loss in the feet and lower extremities, careful daily foot inspection for signs of trauma and infection are essential to prevent serious infections and other complications.[clevelandclinicmeded.com]

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