Abstract
Approximately 3 percent of all patients with SCLC and the 0,2 percent of all patients with cancer of the ovaries they will develop a paraneoplastic neurological syndrome (PNS). In most cases the neurological syndrome precedes the diagnosis of the primary cancer. Although there are multiple pesentaciones, there are some classical syndromes with well definite diagnostic criteria and frequent well recognized cancers. When the PNS precedes the cancer diagnostic and the patients are initially seen by the neurologist this should have the clinical insight to recognize the disorder. This review includes the clinical characteristics of four classical paraneoplasic syndromes: limbic encephalitis, cerebellar degeneration, subacute sensitive neuronopathy and miasteniform syndrome of Lambert-Eaton (LEMS). The most frequent types of cancer that cause limbic encephalitis are: the small cells lung cancer (SCLC) and the testicular cancer. They can cause 60 percent of all syndromes. The most frequent antibodies in the SCLC and limbic encephalitis
are ANTI Hu and CV2/CRMP5, while in the patients with testicular cancer are the anti-Ma2. Frequently these patients develop dysarthria and dysphagia.
The cancer most identified, in around 84 percent of the patients with cerebellar degeneration comes from: ovary (ANTI I), or lung (ANTI Hu), or breast (ANTI Ri), or Hodgkin disease (ANTI Tr) the illness itself is characterize by ataxia and vertigo. Opposed to other paraneoplastic syndromes, the anti-Yo associate to cerebellar degeneration occurs with greater frequency in patients that already have diagnosed one ovarian cancer. The sensitive neuronopathy cause painful dysesthesia and neuronophatic and demielinizating alterations in electrophysiological studies. The Eaton-Lambert syndrome is characterized for proximal weakness in legs more than in arms and by symptoms of autonomous dysfunction (drought mouth, orthostatic hypotension and, erectile dysfunction) and decrease or absence of reflex. Electrophysiological studies reveal small and composed action potentials in muscles, with a marked increment in the answer to repetitive stimuli on the nerve. In about 60 percent of the patients, this syndrome is associated to SCLC.
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