About Paraneoplastic Neurological Disorders (PND) > Central Nervous System (Brain and Spinal Cord) > Paraneoplastic Encephalomyelitis

Paraneoplastic Encephalomyelitis

In paraneoplastic encephalomyelitis multiple areas of the nervous system are involved at the same time. Patients usually develop symptoms or deficits that combined those described in “limbic encephalitis,” cerebellar degeneration, “brainstem encephalitis, and/or “myelitis.” In addition, some patients also develop sensory deficits caused by involvement of the neurons involved in the sensory nerves (see “sensory neuronopathy”).

There are several paraneoplastic antibodies and cancers associated with paraneoplastic encephalitis. The most frequently found antibodies are anti-Hu and anti-CV2/CRMP5 (Figure).

Patients with anti-Hu antibodies are usually heavy smokers, and the associated tumor is usually a small-cell lung cancer. These patients frequently have sensory symptoms ( sensory neuronopathy), and subsequently may develop many of the other symptoms seen in sensory neuronopathy.

Patients with anti-CV2/CRMP5 antibodies may also have small-cell lung cancer, but other tumors (such as thymoma among others) can occur. Patients with these antibodies may develop any of the symptoms described in this section or which of the above. They may also have involuntary abnormal movements of the arms or legs (e.g. chorea), visual problems due to inflammation in the eye (uveitis), or peripheral neuropathy.

The best chance to improve or stabilize the symptoms of encephalomyelitis associated with either with anti-Hu or anti-CV2 antibodies is to treat the tumor and give immunotherapy.

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