Hostname: page-component-cb9f654ff-hn9fh Total loading time: 0 Render date: 2025-08-08T20:46:06.493Z Has data issue: false hasContentIssue false
  • English
  • Français

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.
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

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.

Information

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

References

1.Denny-Brown, D.Primary sensory neuropathy with muscular changes associated with carcinoma. J Neurol Neurosurg Psychiatry 1948; 11: 73–87.CrossRefGoogle ScholarPubMed
2.Smith, WT, Whitfield, AGW.Malignant sensory neuropathy. Lancet 1955; 1: 282–285.CrossRefGoogle Scholar
3.Heathfield, KWG, Williams, JRB.Peripheral neuropathy and myopathy associated with bronchogenic carcinoma. Brain 1954; 77: 122–137.CrossRefGoogle ScholarPubMed
4.Bickerstaff, ER, Woolf, AL.Case 1. Carcinomatous sensory neuropathy associated with a pin head-sized anaplastic carcinoma and plasma cell “encephalitis.” Birmingham Med Rev 1958; 20: 355–360.Google Scholar
5.Croft, PB, Urich, H, Wilkinson, M.Peripheral neuropathy of sensorimotor type associated with malignant disease. Brain 1967; 90: 31–66.CrossRefGoogle ScholarPubMed
6.Henson, RA, Urich, H.Cancer and the Nervous System: The Neurological Manifestations of Systemic Malignant Disease. Boston: Blackwell Scientific Publications, 1982; 378–380.Google Scholar
7.Horwich, MS, Cho, L, Porro, RS, et al. Subacute sensory neuropathy: a remote effect of carcinoma. Ann Neurol 1977; 2: 7–19.CrossRefGoogle ScholarPubMed
8.Berciano, J, Gutierrez, J, Figols, J, et al. Polineuropatia sensorial asociada a adenocarcinoma pancreático. Estudio clinicopatológico de un casa seguido 5 años. Rev Clin Esp 1983; 170: 295–297.Google Scholar
9.Sagar, HJ, Read, DJ.Subacute sensory neuropathy with remission: an association with lymphoma. J Neurol Neurosurg Psychiatry 1982; 45: 83–85.CrossRefGoogle ScholarPubMed
10.Ohnishi, A, Ogawa, M.Preferential loss of large lumbar primary sensory neurons in carcinomatous sensory neuropathy. Ann Neurol 1986; 20: 102–104.CrossRefGoogle ScholarPubMed
11.Graus, F, Elkon, KB, Cordon-Cardo, C, et al. Sensory neuronopathy and small cell lung cancer: antineuronal antibody that also reacts with the tumor. Am J Med 1986; 80: 45–52.CrossRefGoogle ScholarPubMed
12.Daube, JR.Nerve conduction studies. In: Aminoff, MJ, ed. Electrodiagnosis in Clinical Neurology. New York: Churchill Living-stone, 1980; 229–264.Google Scholar
13.Lennon, VA.Anti-Purkinje cell cytoplasmic and neuronal nuclear antibodies aid diagnosis of paraneoplastic autoimmune neurological disorders (letter to the editor). J Neurol Neurosurg Psychiatry 1989; 52: 1438–1439.CrossRefGoogle Scholar
14.O’Neill, JH, Murray, NMF, Newsom-Davis, J.The Lambert-Eaton myasthenic syndrome: a review of 50 cases. Brain 1988; 111: 577–596.CrossRefGoogle ScholarPubMed
15.Rosenow, EC III, Carr, DT.Bronchogenic carcinoma. CA 1979; 29: 233–245.Google ScholarPubMed
16.Asbury, AK, Johnson, PC.Pathology of Peripheral Nerve. Philadelphia: WB Saunders, 1978; 82.Google ScholarPubMed
17.Anderson, NE, Rosenblum, MK, Graus, F, et al. Autoantibodies in paraneoplastic syndromes associated with small-cell lung cancer. Neurology 1988; 38: 1391–1398.CrossRefGoogle ScholarPubMed
18.Dalmau, J, Furneaux, HM, Gralla, RJ, et al. Detection of the anti-Hu antibody in the serum of patients with small cell lung cancer — a quantitative Western blot analysis. Ann Neurol 1990; 27: 544–552.CrossRefGoogle ScholarPubMed
19.Chalk, CH, Murray, NMF, Newson-Davis, J, et al. Response of the Lambert-Eaton myasthenic syndrome to treatment of associated small-cell lung carcinoma. Neurology 1990; 40: 1552–1556.CrossRefGoogle ScholarPubMed
20.Schaumburg, H, Kaplan, J, Windebank, A, et al. Sensory neuropathy from pyridoxine abuse: a new megavitamin syndrome. N Engl J Med 1983; 309: 445–448.CrossRefGoogle ScholarPubMed
21.Mollman, JE.Cisplatin neurotoxicity (editorial). N Engl J Med 1990; 322: 126–127.CrossRefGoogle Scholar
22.Denny-Brown, D.Hereditary sensory radicular neuropathy. J Neurol Neurosurg Psychiatry 1951; 14: 237–252.CrossRefGoogle ScholarPubMed
23.Griffin, JW, Cornblath, DR, Alexander, E, et al. Ataxic sensory neuropathy and dorsal root ganglionitis associated with Sjogren’s syndrome. Ann Neurol 1990; 27: 304–315.CrossRefGoogle ScholarPubMed
24.Windebank, AJ, Blexrud, MD, Dyck, PJ, et al. The syndrome of acute sensory neuropathy: clinical features and electrophysiologic and pathologic changes. Neurology 1990; 40: 584–591.CrossRefGoogle ScholarPubMed
25.Sterman, AB, Schaumburg, HH, Asbury, AK.The acute sensory neuronopathy syndrome: a distinct clinical entity. Ann Neurol 1980; 7: 354–358.CrossRefGoogle ScholarPubMed
26.Dalakas, M.Chronic idiopathic ataxic neuropathy. Ann Neurol 1986; 19: 545–554.CrossRefGoogle ScholarPubMed