Diagnosis and treatment of paraneoplastic neurological disorders
Paraneoplastic neurological disorders are an extensive and heterogeneous group of neurological disorders mediated by immune responses that can affect any part of the nervous system and are characterized by neuronal loss and perivascular inflammatory infiltrates. Many paraneoplastic neurological disorders are associated with specific antibodies that recognize antigens expressed both in the tumor and in the nervous system, suggesting that the cause of some paraneoplastic neurological disorders is an initial immune response against tumors that are misdirected to the nervous system. The diagnosis of paraneoplastic neurological disorder is a diagnosis of exclusion since neurological complications of cancer itself, or its treatment, are significantly more frequent. The rapid recognition of the syndrome is crucial since early diagnosis and prompt aggressive treatment of the malignancy, in conjunction with immunotherapy, may stabilize or improve the paraneoplastic neurological disorder. However, the diagnosis of paraneoplastic neurological disorders is difficult and often missed.
