Paraneoplastic movement disorders

Curr Neurol Neurosci Rep. 2009 Jul;9(4):285-91. doi: 10.1007/s11910-009-0043-4.

Abstract

Neurologic paraneoplastic syndromes (NPSs) result from damage to the nervous system due to the remote effects of cancer not related to metastasis, infection, or metabolic derangements. NPSs are rare, affecting 1 in 10,000 patients with cancer. Pathogenesis is likely related to the immune mechanisms: normal neural tissue is mistakenly attacked due to the similarity in the onconeural antigens expressed by the tumor cells. Among the various "classic" and other NPSs, this review focuses on paraneoplastic movement disorders, including ataxia due to cerebellar degeneration, stiff-person syndrome, opsoclonus-myoclonus syndrome, chorea, parkinsonism, and tremor. The recently described syndrome of paraneoplastic anti-N-methyl-D-aspartate receptor encephalitis is also included, given that these patients have complex movements such as stereotypies and dyskinesias in addition to psychiatric symptoms, altered sensorium, and other neurologic signs. Although variable, treatment and prognosis of NPSs rely heavily on treatment of the underlying malignancy and immunotherapy.

Publication types

  • Review

MeSH terms

  • Ataxia / diagnosis
  • Ataxia / physiopathology
  • Ataxia / therapy
  • Autoimmune Diseases of the Nervous System / diagnosis
  • Autoimmune Diseases of the Nervous System / physiopathology
  • Autoimmune Diseases of the Nervous System / therapy
  • Chorea / diagnosis
  • Chorea / physiopathology
  • Chorea / therapy
  • Female
  • Humans
  • Male
  • Movement Disorders* / diagnosis
  • Movement Disorders* / physiopathology
  • Movement Disorders* / therapy
  • Opsoclonus-Myoclonus Syndrome / diagnosis
  • Opsoclonus-Myoclonus Syndrome / physiopathology
  • Opsoclonus-Myoclonus Syndrome / therapy
  • Paraneoplastic Syndromes, Nervous System* / diagnosis
  • Paraneoplastic Syndromes, Nervous System* / physiopathology
  • Paraneoplastic Syndromes, Nervous System* / therapy
  • Parkinsonian Disorders / diagnosis
  • Parkinsonian Disorders / physiopathology
  • Parkinsonian Disorders / therapy
  • Receptors, N-Methyl-D-Aspartate / immunology
  • Sex Factors
  • Tremor / diagnosis
  • Tremor / physiopathology
  • Tremor / therapy

Substances

  • Receptors, N-Methyl-D-Aspartate