Paraneoplastic neurological syndromes

Almost any part of the nervous system can be affected by paraneoplastic syndromes. It is important to recognise paraneoplastic neurological syndromes (PNS), for several reasons. They usually predate symptoms of the malignancy, and identification should lead to a search for the primary tumour. PNS may also predate the clinical appearance of metastatic deposits or tumour recurrence. In a patient with a diagnosed malignancy there is a tendency to consider effects at remote sites to be considered as secondary deposits, and the patient may be deprived of appropriate therapy owing to an incorrect diagnosis of multiple secondary deposits. Most of the PNS are of immunological aetiology, but immunosuppression is not beneficial except in a few. Appropriate treatment for the primary tumour usually helps in improving the PNS symptoms. doi:10.4038/cmj.v53i4.290 Ceylon Medical Journal Vol. 53, No. 4, December 2008 148-152