Update on Paraneoplastic Neurologic Disorders

Abstract

Abstract Learning Objectives After completing this course, the reader will be able to: Identify the symptoms of paraneoplastic neurologic disorders (PNDs) and, when appropriate, include PNDs in the differential diagnosis when evaluating patients with systemic cancers.Describe the relationship of paraneoplastic antibodies and specific syndromes, where present, and their use in diagnosis of PND. CME This article is available for continuing medical education credit at CME.TheOncologist.com When patients with cancer develop neurologic symptoms, common causes include metastasis, infections, coagulopathy, metabolic or nutritional disturbances, and neurotoxicity from treatments. A thorough clinical history, temporal association with cancer therapies, and results of ancillary tests usually reveal one of these mechanisms as the etiology. When no etiology is identified, the diagnosis considered is often that of a paraneoplastic neurologic disorder (PND). With the recognition that PNDs are more frequent than previously thought, the availability of diagnostic tests, and the fact that, for some PNDs, treatment helps, PNDs should no longer be considered diagnostic zebras, and when appropriate should be included in the differential diagnosis early in the evaluation.