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Paraneoplastic Syndrome & Sensory Neuropathy

Paraneoplastic syndromes occur during many forms of cancer. These syndromes are accompanied by many types of neuropathy. Paranoeplastic syndromes and linked neuropathy are thought to be secondary symptoms due to substances released by tumors. Symptoms can also arise due to antibodies that are fighting against the cancerous tumors. These antibodies then cross-react with other body tissues. Approximately 20 percent of cancer patients exhibit paraneoplastic syndromes. These often go unnoticed.

  1. Cancers Associated with Paraneoplastic Syndromes

    • Many types of cancer involve paraneoplastic syndromes. The most common include lung carcinoma, hepatocellular carcinoma, renal carcinoma, leukemias, breast tumors, lymphomas, neural cancers, ovarian tumors, pancreatic cancers and gastric cancers.

    Peripheral Neuropathy

    • The most common neuropathy is peripheral neuropathy. It is usually distal (further away from the core of the body), producing mild sensory loss, weakness and absent reflexes. This type of neurologic paraneoplastic syndrome is hard to distinguish from other symptoms that accompany various chronic illnesses.

    Subacute Sensory Neuropathy

    • Subacute sensory neuropathy is a rare but more specific form of peripheral neuropathy. There is a degeneration of the dorsal root ganglia. Ataxia is experienced, but with little development of motor weakness. This is common in lung cancer, and there is no cure.

      Guillain-Barré syndrome also falls within the peripheral neuropathy category. This is common in people diagnosed with Hodgkin's lymphoma.

    Eaton-Lambert Syndrome

    • Eaton-Lambert syndrome is an immune response. It is myasthenia-like in nature. This syndrome causes weakness in the limbs. Bulbar and ocular muscles are spared. This syndrome is caused by an impaired release of acetylcholine from nerve terminals. It is presynaptic. This syndrome can develop, precede or occur after there has been a diagnosis of cancer. Most commonly found in men, Eaton-Lambert syndrome often accompanies small or oat cell carcinoma in 70 percent of cases.

      Patients may experience weakness, fatigue, pain in proximal muscles, dry mouth, peripheral paresthesias, ptosis and erectile dysfunction. Patients will usually have reduced or lost deep tendon reflexes.

    Subacute Cerebellar Degeneration

    • Subacute cerebellar degeneration causes progressive arm and leg ataxia that is bilateral. Neurological signs may be present including dementia, nystagmus, ophthalmoplegia, extensor plantar signs, dysarthria and arm involvement. This degeneration is progressive and disabling. This condition can precede cancer by weeks or years. The most common forms of cancer that accompany this condition are breast and ovarian cancer. Improvement is possible following successful cancer treatment.

    Subacute Motor Neuropathy

    • Subacute motor neuropathy is rare. Weakness occurs in the lower and upper extremities without pain. This is most common in people diagnosed with lymphomas. Improvements are often experienced.

    Subacute Necrotizing Myelopathy

    • Subacute necrotizing myelopathy involves ascending motor and sensory loss, which are very rapid. The gray and white matter of the spinal cord is where loss occurs. This leads to paraplegia. Necrosis may be shown on an MRI.

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