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Paraneoplastic neurological syndromes.
Curr Opin Neurol. 2012 Dec; 25(6):795-801.CO

Abstract

PURPOSE OF REVIEW

This review describes relevant advances in paraneoplastic neurological syndromes (PNS) with emphasis on particular syndromes and the impact of antibodies against surface antigens in their management.

RECENT FINDINGS

PNS may present with symptoms that do not raise the suspicion of a paraneoplastic origin. The best example is anti-N-methyl-D-aspartate receptor encephalitis that in adult women frequently associates with ovarian teratoma. An electroencephalogram pattern described as 'extreme delta brush' was recently identified in 30% of patients with this disorder. Isolated myelopathy may have a paraneoplastic origin associated with amphiphysin or CV2 (CRMP5) antibodies. Jaw dystonia and laryngospasm can be the predominant symptom of the brainstem encephalitis associated with Ri antibodies. γ-Aminobutyric acid (GABA)(B) receptor antibodies are the most common antibodies found in patients with limbic encephalitis and small cell lung cancer, and contactin-associated protein 2 antibodies in patients with Morvan's syndrome and thymoma. Lastly, a recent study identified delta/notch-like epidermal growth factor-related receptor (DNER) as the target antigen of Tr antibodies, a marker of cerebellar ataxia and Hodgkin's lymphoma.

SUMMARY

The number of antibodies relevant to PNS is now expanded to those against surface antigens. These antibodies do not confirm the paraneoplastic origin of the syndrome but predict a better response to immunotherapy.

Authors+Show Affiliations

Service of Neurology, Hospital Clinic, Universitat de Barcelona and Institut d'Investigació Biomèdica August Pi i Sunyer, Barcelona, Spain. fgraus@clinic.ub.esNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

23041955

Citation

Graus, Francesc, and Josep Dalmau. "Paraneoplastic Neurological Syndromes." Current Opinion in Neurology, vol. 25, no. 6, 2012, pp. 795-801.
Graus F, Dalmau J. Paraneoplastic neurological syndromes. Curr Opin Neurol. 2012;25(6):795-801.
Graus, F., & Dalmau, J. (2012). Paraneoplastic neurological syndromes. Current Opinion in Neurology, 25(6), 795-801. https://doi.org/10.1097/WCO.0b013e328359da15
Graus F, Dalmau J. Paraneoplastic Neurological Syndromes. Curr Opin Neurol. 2012;25(6):795-801. PubMed PMID: 23041955.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Paraneoplastic neurological syndromes. AU - Graus,Francesc, AU - Dalmau,Josep, PY - 2012/10/9/entrez PY - 2012/10/9/pubmed PY - 2013/5/4/medline SP - 795 EP - 801 JF - Current opinion in neurology JO - Curr. Opin. Neurol. VL - 25 IS - 6 N2 - PURPOSE OF REVIEW: This review describes relevant advances in paraneoplastic neurological syndromes (PNS) with emphasis on particular syndromes and the impact of antibodies against surface antigens in their management. RECENT FINDINGS: PNS may present with symptoms that do not raise the suspicion of a paraneoplastic origin. The best example is anti-N-methyl-D-aspartate receptor encephalitis that in adult women frequently associates with ovarian teratoma. An electroencephalogram pattern described as 'extreme delta brush' was recently identified in 30% of patients with this disorder. Isolated myelopathy may have a paraneoplastic origin associated with amphiphysin or CV2 (CRMP5) antibodies. Jaw dystonia and laryngospasm can be the predominant symptom of the brainstem encephalitis associated with Ri antibodies. γ-Aminobutyric acid (GABA)(B) receptor antibodies are the most common antibodies found in patients with limbic encephalitis and small cell lung cancer, and contactin-associated protein 2 antibodies in patients with Morvan's syndrome and thymoma. Lastly, a recent study identified delta/notch-like epidermal growth factor-related receptor (DNER) as the target antigen of Tr antibodies, a marker of cerebellar ataxia and Hodgkin's lymphoma. SUMMARY: The number of antibodies relevant to PNS is now expanded to those against surface antigens. These antibodies do not confirm the paraneoplastic origin of the syndrome but predict a better response to immunotherapy. SN - 1473-6551 UR - https://www.unboundmedicine.com/medline/citation/23041955/Paraneoplastic_neurological_syndromes_ L2 - http://dx.doi.org/10.1097/WCO.0b013e328359da15 DB - PRIME DP - Unbound Medicine ER -