Antoine Jean-Christophe, Camdessanché Jean-Philippe
Department of Neurology, University Hospital of Saint-Étienne, Saint-Étienne, France.
Presse Med. 2013 Jun;42(6 Pt 2):e235-44. doi: 10.1016/j.lpm.2013.01.059. Epub 2013 Apr 19.
Paraneoplastic neurological syndromes are rare but can affect any part of the peripheral nervous system (PNS) including motor neurons, sensory ganglia, nerve roots, plexuses, cranial and peripheral nerves, and neuromuscular junctions. The type of cancer, lymphoma or solid tumour, is a determinant factor of the underlying mechanism. With solid tumour, antibodies directed to intracellular (anti-Hu or anti-CV2/CRMP5 antibodies) or surface antigens (anti-VGCC,or LGI1 and Caspr2 antibodies) have been identified while with lymphoma, the neuropathy is usually linked to a monoclonal gammopathy. This review discusses the different etiologies and mechanisms of paraneoplastic disorders of the PNS in patients emphasising their evaluation, diagnosis and treatment.
副肿瘤性神经系统综合征较为罕见,但可累及周围神经系统(PNS)的任何部位,包括运动神经元、感觉神经节、神经根、神经丛、颅神经和周围神经以及神经肌肉接头。癌症类型,即淋巴瘤或实体瘤,是潜在机制的决定因素。对于实体瘤,已鉴定出针对细胞内(抗Hu或抗CV2/CRMP5抗体)或表面抗原(抗VGCC、LGI1和Caspr2抗体)的抗体,而对于淋巴瘤,神经病变通常与单克隆丙种球蛋白病有关。本综述讨论了PNS副肿瘤性疾病在患者中的不同病因和机制,重点介绍了其评估、诊断和治疗。