Paraneoplastic syndromes of the nervous system

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Preparing for your appointment

By Mayo Clinic staff

Most people with paraneoplastic syndrome experience neurological problems before there is a diagnosis of cancer or any indication of cancer. So, you're likely to start by seeing your primary care doctor about your symptoms. You may then be referred to a specialist in nervous system disorders (neurologist) or a cancer specialist (oncologist).

Questions from your doctor
Depending on the type and severity of symptoms, it may be important for a friend or family member to be at the appointment — to help answer questions and to provide moral support. Be prepared to answer the following questions:

  • Have you experienced any muscle weakness or lack of coordination?
  • Have you experienced any unusual or involuntary muscle movements?
  • Have you had any unusual vision problems?
  • Do you have any problems chewing, swallowing or speaking?
  • Do you have any difficulty breathing?
  • Have you had any seizures? How long have they lasted?
  • Have you experienced dizziness or nausea?
  • Do you have trouble sleeping, or have your sleep patterns changed?
  • Are you having difficulty performing everyday tasks with your hands?
  • Have you experienced any numbness or tingling in your limbs?
  • Have you experienced a significant change in mood?
  • Have you been seeing or hearing things that others are not aware of?
  • Have you had any memory problems?
  • When did the symptoms begin?
  • Have the symptoms worsened since you first noticed them?
  • Have you been diagnosed with cancer?
  • What medications do you take, including over-the-counter drugs and dietary supplements? What is the daily dosage of each?
  • Have any close relatives had cancer? If so, what types of cancer?
  • Have you ever smoked?

Questions for your doctor
Questions you may want to ask your doctor include:

  • What diagnostic tests are you going to order?
  • Which specialists will I need to see?
  • What is the likely time frame for completing tests and getting results?
  • How will you communicate results to me?
  • What things are you looking for with the tests?
  • What conditions are you trying to rule out?
Tests and diagnosis Risk factors
References
  1. NINDS paraneoplastic syndrome information page. National Institutes of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/paraneoplastic/paraneoplastic.htm. Accessed Oct. 4, 2010.
  2. Dalmau J, et al. Paraneoplastic neurologic syndromes. In: Abeloff M, et al., eds. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingston Elsevier; 2008. http://www.mdconsult.com/das/book/body/221079415-3/1062999853/1709/56.html#4-u1.0-B978-0-443-06694-8..50055-5--cesec11_1589. Accessed Oct. 4, 2010.
  3. Pelosof LC, et al. Paraneoplastic syndromes: An approach to diagnosis and treatment. Mayo Clinic Proceedings. 2010;85:838.
  4. Toothaker TB, et al. Paraneoplastic neurological syndromes: A review. Neurologist. Jan 2009;15:21.
  5. Dalmau J, et al. Paraneoplastic syndromes of the CNS. Lancet Neurology. 2008;7:327.
  6. Giglio P, et al. Neurologic complications of cancer and its treatment. Current Oncology Reports. 2010;12:50a.
  7. NINDS Isaac's syndrome information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/Isaacs_syndrome/Isaacs_syndrome.htm. Accessed Oct. 5, 2010.
  8. Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Oct. 5, 2010.
  9. Therapeutic hematheresis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec11/ch146/ch146f.html. Accessed Oct. 7, 2010.
  10. Passive immunization. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec14/ch169/ch169c.html?qt=immunoglobulin&alt=sh. Accessed Oct. 7, 2010.
  11. McKeon A, et al. Positron emission tomography-computed tomography in paraneoplastic neurologic disorders: Systematic analysis and review. Archives of Neurology. 2010;67:322.
  12. Pittock SJ, et al. Paraneoplastic Autoimmunity Affecting the Nervous System. In: Baehring JM, et al., eds. Brain Tumors: Practical Guide to Diagnosis and Management. New York, N.Y.: Informa Healthcare; 2007:515.
  13. Lachance DH, et al. Paraneoplastic neurological autoimmunity. In: Kalman B, et al., eds. Neuroimmunology in Clinical Practice. Hoboken, N.J.: Wiley-Blackwell; 2007:210.
  14. Harper CM, et al. Lambert-Eaton syndrome. In: Kaminski HJ. Current Clinical Neurology: Myasthenia Gravis and Related Disorders. Totowa, N.J.: Humana Press; 2009:269.
  15. Pittock SJ (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 14, 2010.
DS00840 March 3, 2011

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