[Evaluation of nervous system disorders during the course of gastric carcinoma on the basis of clinical electrophysiologic analysis].

The complex of neurological symptoms, which occur in the course of neoplasms of the internal organs and caused by the distant effect of the neoplasm on the nervous system, excluding other factors which could be responsible for changes in the nervous system, is called the paraneoplastic syndrome (PS). Pathogenesis of PS has not been clearly explained so far. Besides toxic, metabolic and infectious causes, the autoimmunologic one is taken into consideration. Paraneoplastic syndrome is mostly evoked by the oat cell carcinoma, subsequently by the breast, ovary and rarely by gastric carcinoma. The aim of the work was to determine: 1) the changes in the electroneurographic as well as visual and auditory evoked potentials examinations in the course of gastric carcinomas, 2) the influence of the treatment applied in gastric carcinomas on changes in visual and auditory evoked potentials and electroneurographic examinations. The examined group included 33 patients with diagnosed gastric carcinoma and having no clinical symptoms of lesion of the central and peripheral nervous systems. The results were compared to the control group, which consisted of healthy volunteers and patients after ventricular resection because of the chronic peptic ulcer disease. Clinical, neurographic as well as visual and auditory evoked potentials examinations were carried out three times. I.--just after the diagnosis of the neoplastic disease, II.--after end of treatment, III.--after 18 months (on average) since the end of the therapy. All patients had operative treatment. A part of them had supplementary chemotherapy--EEP cycle (Etoposide, Epirubicin, Cisplatin) or 5-fluorouracil. On the basis of the performed examinations of patients with gastric carcinoma, without clinical symptoms of lesions of the nervous system, primary axonal sensory-motoric neuropathic changes were observed in 36%. Changes in visual and auditory evoked potentials were found only in patients over 65 years old in over 50%. In patients after chemotherapy they were observed in visual and auditory evoked potentials and electroneurographic examinations, which could be caused by neurotoxic side-effect of the cytostatics applied.