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Paraneoplastic sensory neuropathy

  • W. Grisold
  • M. Drlicek
  • P. Hitzenberger
  • K. Jellinger
  • U. Liszka
  • T. Paternostro

Summary

Sensory neuropathy and its rare variant sensory neuronopathy (or pure sensory ataxic) neuronopathy are frequently considered in the context of paraneoplastic neurologic disorders. From the figures in literature concerning the incidence and further diagnostic value of paraneoplastic neuropathy it is obvious that the pure sensory type is a rare association.

Uncharacteristic sensory-motor neuropathies are most commonly observed. In a large group of cancer patients, by careful sensory testing, involvement of large myelinated fibres in the dorsal root was noted. Some authors have suggested the appearance of sensory neuropathy to be caused inflammatory mechanisms. Sensory cranial nerve symptoms or mononeuropathies have been noted in a few patients.

In the past years the appearance of paraneoplastic neuropathies has been attributed to the appearance of circulating antineuronal antibodies.

Very rarely also neoplastic infiltration of peripheral nerves occurs and is clinically indistinguishable from other causes. Three case reports illustrate the topic.

Keywords

Guillain Barre Syndrome Sensory Neuropathy Sensory Symptom Critical Illness Polyneuropathy Lambert Eaton Myasthenic Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Anderson ME, Rosenblum MK, Graus F, Wiley RG, Posner JB (1988) Autoantibodies in paraneoplastic syndromes associated with small cell lung cancer. Neurology 38: 1391–1398PubMedCrossRefGoogle Scholar
  2. 2.
    Asbury AK, Picard EH, Baringer JR (1972) Sensory perineuritis. Arch Neurol 26: 302–312PubMedCrossRefGoogle Scholar
  3. 3.
    Barron SA, Rowland LP, Zimmerman HM (1960) Neuropathy with maligant tumor metastasis. J Nerv Ment Dis 131: 10–31PubMedCrossRefGoogle Scholar
  4. 4.
    Brain Lord, Adams RD (1965) In: Brain WR, Norris FH (eds) The remote effects of cancer on the nervous system. Grune and Stratton: New York, pp 216–221Google Scholar
  5. 5.
    Brashear HR, Bonnin JM, Login IS (1985) Encephalomyeloneuritis simulating Guillain Barré syndrome. Neurology 35: 1146–1151PubMedCrossRefGoogle Scholar
  6. 6.
    Croft PB, Wilkinson M (1963) Carcinomatous neuromyopathy. It’s incidence in patients with carcinoma of the lung and breast. Lancet I: 184–186CrossRefGoogle Scholar
  7. 7.
    Farrel DA, Medsger TA (1982) Neurologic manifestations in progressive systemic sclerosis. Am J Med 73: 57–62CrossRefGoogle Scholar
  8. 8.
    Fukunaga H, Engel AG, Lang B, Newsome Davies J, Vincent A (1983) Passive transfer of Lambert Eaton myasthenic syndrome with IgG from man to mouse depletes the presynaptic membrane active zones. Proc Natl Acad Sci USA 80: 7636–7640PubMedCrossRefGoogle Scholar
  9. 9.
    Furneaux HF, Reich L, Posner JB (1990) Autoantibody synthesis in the central nervous system of patients with paraneoplastic syndromes. Neurology 40: 1085–1091PubMedCrossRefGoogle Scholar
  10. 10.
    Gherardi R, Gaulard P, Prost C, Rocha D, Imbert M, Andre C, Rochant H, Farcet JP (1986) T cell lymphoma revealed by a peripheral neuropathy. Cancer 58: 2710–2716PubMedCrossRefGoogle Scholar
  11. 11.
    Graus F, Ferrer I, Lamarca E (1983) Mixed carcinomatous neuropathy in patients with lung cancer and lymphoma. Acta Neurol Scand 68: 40–48PubMedCrossRefGoogle Scholar
  12. 12.
    Graus F, Cordon-Cardo C, Posner JB (1985) Neuronal antinuclear antibody in the sensory neuronopathy from lung cancer. Neurology 35: 538–543PubMedCrossRefGoogle Scholar
  13. 13.
    Graus F, Elkon KB, Codon-Cardo C, Posner JB (1986) Sensory neuronopathy and small cell lung cancer. Antineuronal antibody that also reacts with the tumor. Am J Med 80: 45–52PubMedCrossRefGoogle Scholar
  14. 14.
    Grisold W, Mokrusa W, Mamoli B, Weber R, Lutz D (1985) Akute myelomonozytäre und Monoblastenleukämie mit polyradikulärer Symptomatik. Wien Klin Wochenschr 16: 662–666Google Scholar
  15. 15.
    Grisold W (1989) Neuromuskuläre Läsionen bei Malignomen. Springer: Wien New YorkCrossRefGoogle Scholar
  16. 16.
    Grisold W, Drlicek M, Liszka U, Popp W (1989) Anti-Purkinje cell antibodies are specific for small cell lung cancer but not for paraneoplastic neurological disorders. J Neurol 236: 64PubMedCrossRefGoogle Scholar
  17. 17.
    Guberman A, Rosenbaum H, Braciale T, Schlaepfer WW (1978) Human neuro-lymphomatosis. J Neurol Sci 36: 1–12PubMedCrossRefGoogle Scholar
  18. 18.
    Haberland C, Cipriani M, Kucuk O, Sarpel G, Ezdinli EZ, Ro JO (1987) Fulminant leukemic polyradiculoneuropathy in a case of B-cell prolymphocytic leukemia. Cancer 60: 1454–1458PubMedCrossRefGoogle Scholar
  19. 19.
    Hartung HP, Heininger K, Schäfer B, Fierz W, Toyka KV (1988) Immune mechanisms in inflammatory polyneuropathy. Adv Neuroimmunol 540: 122–161Google Scholar
  20. 20.
    Hawley R, Cohen M, Saini N, Armbrustmacher V (1980) The carcinomatous neuromyopathy of oat cell lung cancer. Ann Neurol 7: 65–72PubMedCrossRefGoogle Scholar
  21. 21.
    Henson RA, Hoffman HL, Urich H (1965) Encephalomyelitis with carcinoma. Brain 88: 449PubMedCrossRefGoogle Scholar
  22. 22.
    Henson RA, Urich H (1982) Cancer and the nervous system. Blackwell Scientific: OxfordGoogle Scholar
  23. 23.
    Ince PG, Shaw PJ, Fawcett PRW, Bates D (1987) Demyelinating neuropathy due to primary IgM kappa B-cell lymphoma of peripheral nerve. Neurology 37: 1231–1235PubMedCrossRefGoogle Scholar
  24. 24.
    Jellinger K (1983) Maligne Lymphome und Leukämien im Zentralnervensystem. Verh Dtsch Ges Path 67: 556–573Google Scholar
  25. 25.
    Johnson PC, Rolack LA, Hamilton RH, Laguna JF (1979) Paraneoplastic vasculitis of nerve: a remote effect of cancer. Ann Neurol 5: 437–444PubMedCrossRefGoogle Scholar
  26. 26.
    Kimmel DW, O’Neill BP, Lennon VA (1988) Subacute sensory neuronopathy associated with small cell lung carcinoma: diagnosis aided by autoimmune serology. Mayo Clin Proc 63: 29–32PubMedCrossRefGoogle Scholar
  27. 27.
    Klingon GH (1965) The Guillain Barré syndrome associated with cancer. Cancer 18: 157–163PubMedCrossRefGoogle Scholar
  28. 28.
    Kuroda Y, Nakata H, Kakigi R, Oda K, Shibasaki H, Nakashiro H (1989) Human neuro-lymphomatis by adult T-cell leukemia. Neurology 39: 144–146PubMedCrossRefGoogle Scholar
  29. 29.
    Lamarche J, Vital C (1987) Carcinomatous neuropathy. An ultrastructural study of ten cases. Ann Pathol 2: 98–105Google Scholar
  30. 30.
    Layzer RB (1985) Neuromuscular manifestations of systemic disease. FA Davies: PhiladelphiaGoogle Scholar
  31. 31.
    Lecky BRF, Hughes RAC, Murray NMF (1987) Trigeminal sensory neuropathy. Brain 110: 1463–1486PubMedCrossRefGoogle Scholar
  32. 32.
    Lipton RB, Bradley SG, Dutcher JP, Portenoy RK (1987) Quantitative sensory testing demonstrates that subclinical sensory is prevalent in patients with cancer. Arch Neurol 44: 944–946PubMedCrossRefGoogle Scholar
  33. 33.
    Logothesis J, Kennedy WR, Ellington A (1968) Cryoglobulinemic neuropathy: incidence and clinical characteristics. Arch Neurol 19: 389–397CrossRefGoogle Scholar
  34. 34.
    Massey EW, Moore J, Schold SC (1981) Mental neuropathy from systemic cancer. Neurology 31: 1277–1281PubMedCrossRefGoogle Scholar
  35. 35.
    Ohnishi A, Ogawa M (1986) Preferential loss of large lumbar primary sensory neurons in carcinomatous sensory neuropathy. Ann Neurol 20: 102–104PubMedCrossRefGoogle Scholar
  36. 36.
    Portmann G, Robin JL, Berlendis PA (1952) Les paresthesies precancereuses. Le sud med et chir 85: 1622Google Scholar
  37. 37.
    Teräväinen H, Larsen A (1977) Some features of the neuromuscular complications of pulmonary carcinoma. Ann Neurol 2: 495–502PubMedCrossRefGoogle Scholar
  38. 38.
    Thomas FP, Vallejos U, Foitl DR, et al (1990) B cell small lymphocytic lymphoma and chronic lymphocytic leukemia with peripheral neuropathy: two cases with neuropathol-ogical findings and lymphocyte marker analysis. Acta Neuropathol 80: 198–203PubMedCrossRefGoogle Scholar
  39. 39.
    Thomas PK, Eliasson SG (1984) Neuropathy associated with systemic disease. Diabetic neuropathy. In: Dyck PJ, Thomas PK, Lambert EH, Bunge R (eds) Peripheral neuropathy. Saunders: Philadelphia, pp 1773–1810Google Scholar
  40. 40.
    Trojaborg W, Frantzen E, Anderson I (1969) Peripheral neuropathy and myopathy associated with carcinoma of the lung. Brain 92: 71–77PubMedCrossRefGoogle Scholar
  41. 41.
    Vallat JM, Leboutet MJ, Hugon J, et al (1986) Acute pure sensory paraneoplastic neuropathy with perivascular endoneurial inflammation: ultrastructural study. Neurology 36: 1395–1399PubMedCrossRefGoogle Scholar
  42. 42.
    Vincent D, Dubas F, Hauw JJ (1986) Nerve and muscle microvasculitis in peripheral neuropathy: a remote effect of cancer? J Neurol Neurosurg Psychiatry 49: 1007–1010PubMedCrossRefGoogle Scholar
  43. 43.
    Vital C, Vital A (1989) T-cell leukemic lymphomatosis. Neurology 39: 1272PubMedCrossRefGoogle Scholar
  44. 44.
    Wartenberg R (1957) Neuritis, sensible Neuritis, Neuralgie. Georg Thieme: StuttgartGoogle Scholar
  45. 45.
    Zdochodne DW, Bolton CF, Wells GA (1987) Critical illness polyneuropathy. Brain 110: 819–820CrossRefGoogle Scholar
  46. 46.
    Zuber M, Gherardi R, Imbert M, Gaulard P, Kuentz M, Poirier J (1987) Peripheral neuropathy with distal nerve infiltration revealing a diffuse pleiomorphic malignant lymphoma. J Neurol 235: 61–62PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 1995

Authors and Affiliations

  • W. Grisold
    • 1
  • M. Drlicek
    • 2
  • P. Hitzenberger
    • 1
  • K. Jellinger
    • 2
  • U. Liszka
    • 2
  • T. Paternostro
    • 2
  1. 1.Neurologische Abteilung des Kaiser Franz Josef SpitalsViennaAustria
  2. 2.Ludwig Boltzmann Institut für klinische NeurobiologieViennaAustria

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