Paraneoplastic syndromes of the nervous system is a rare condition with prevalence rates of approximately 1 in 10,000,000 people per year. Paraneoplastic syndromes can also affect other organ systems including hormone (endocrine), skin (dermatologic), blood (hematologic) and joints (rheumatologic). Paraneoplastic events may also in part explain some of the most common symptoms of cancer, such as fatigue, loss of appetite for food (anorexia) and weight loss. Paraneoplastic syndromes of the nervous system occur when cancer-fighting agents of the immune system also attack parts of the brain, spinal cord, peripheral nerves or muscle.
Signs and symptoms of paraneoplastic syndromes of the nervous system usually develop relatively quickly, often over days to weeks. Signs and symptoms vary depending on the body part being injured, and may include: • Difficulty walking • Difficulty maintaining balance • Loss of muscle tone or weakness • Loss of fine motor skills • Difficulty swallowing • Slurred speech • Memory loss • Vision problems
Treatment of neurological paraneoplastic syndromes involves treating the cancer and, in some cases, suppressing the immune response that's causing your signs and symptoms. Your treatment will depend on the specific type of paraneoplastic syndrome you have, but it may include the following options.
Medications: In addition to drugs, such as chemotherapy, to combat your cancer, your doctor may prescribe one or more of the following drugs to stop your immune system from attacking your nervous system:
Corticosteroids, such as prednisone, inhibit inflammation. Serious long-term side effects include weakening of the bones (osteoporosis), diabetes, high blood pressure, high cholesterol and others.
Immunosuppressants slow the production of disease-fighting white blood cells. Side effects include an increased risk of infections. Drugs may include azathioprine (Imuran) and cyclophosphamide (Cytoxan). Depending on the type of neurological syndrome and symptoms, other medications may include:
Anti-seizure medications, which may help control seizures associated with syndromes that cause electrical instability in the brain.
Medications to enhance nerve to muscle transmission,which may improve symptoms of syndromes affecting muscle function. Some drugs, such as 3,4-diaminopyridine, enhance the release of a chemical messenger that transmits a signal from nerve cells to muscles. Other drugs, such as pyridostigmine (Mestinon, Regonol), prevent the breakdown of these chemical messengers.
Intravenous immunoglobulin (IVIG). Plasmapheresis