Answer:
| NEUROMUSCULAR COMPLICATIONS OF CANCER |
| Site |
Paraneoplastic Syndrome |
Autoantibodies (Associated Cancer) |
| Brain and cranial nerves |
Paraneoplastic cerebellar degeneration |
Anti-Yo (GYN cancer)
Anti-Hu (SCLC)
Anti-Tr (HD)
Anti-Ri (breast cancer) |
|
Opsoclonus-myoclonus (breast cancer) |
Anti-Ri |
|
Carcinoma-associated retinopathy
Optic neuritis |
Anti-recoverin (SCLC) |
|
Limbic encephalitis |
Anti-Hu (SCLC) |
|
Brain stem encephalitis |
Anti-Hu (SCLC) |
| Spinal cord |
Myelitis |
Anti-Hu (SCLC) |
|
Subacute motor neuronopathy |
Anti-Hu (SCLC) |
|
Motor neuron disease/ALS |
Anti-Hu (rarely) |
|
Necrotizing myelopathy |
|
|
Stiff-man syndrome |
Anti-amphiphisin (breast, SCLC) |
| Peripheral nerves and dorsal root ganglia |
Subacute or chronic sensorimotor neuropathy
Acute polyradiculopathy (GBS) |
|
|
Neuropathy associated with plasma cell dyscrasias |
Anti-MAG |
|
Brachial neuritis |
|
|
Mononeuritis multiplex |
|
|
Sensory neuronopathy |
|
|
Autonomic neuronopathy |
|
| Neuromuscular junction |
Lambert-Eaton myasthenic syndrome |
Anti-VGCC |
|
Myasthenia gravis |
Acetylcholine receptor Ab |
| Muscle |
Dermatomyositis/polymyositis |
|
|
Acute necrotizing myopathy |
|
|
Carcinoid myopathy |
|
|
Neuromyopathy |
|
|
Neuromyotonia |
Ab to potassium channels |
|
|
|
|
|
These syndromes frequently occur together as part of paraneoplastic encephalomyelitis/sensory neuronopathy with anti-Hu antibody.
GYN = gynecologic, SCLC = small cell lung cancer, HD = Hodgkin’s disease, ALS = amyotrophic lateral sclerosis,
MAG = myelin-associated glycoprotein, Ab = antibody, VGCC = voltage-gated calcium channel, GBS = Guillain-
Barré syndrome,
From Schiff D, et al: Neurologic emergencies in cancer patients. Neurol Clin 16:449-481, 1998, with permission. |
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