Clinical Characteristics, Treatment and Outcomes of Patients with Paraneoplastic Neuropathies. A Retrospective Single-Center Study in Argentina.
Francisco Caiza-Zambrano1, Fabio Gonzalez1, Julio Galarza1, Mauricio Benetti1, Claudia Uribe Roca1, Pablo Bonardo1, Manuel Fernández Pardal1, Luciana León Cejas1, Ricardo Reisin1
1Department of Neurology, Hospital Británico de Buenos Aires
Objective:
To describe the clinical features, treatments and outcomes in patients diagnosed with Paraneoplastic Neuropathies (PN).
Background:
Peripheral neuropathy represents one of the most common presentations of paraneoplastic neurological disorders. Being a rare entity, clinical suspicion is extremely important.
Design/Methods:
Medical records of PN patients between 2010 and 2021 were reviewed.
Results:
Nineteen patients were included, 68% (13/19) were women, and the mean age at symptom onset was 56.26 years (SD 11.9). In most cases (73.7%) the onset of symptoms was subacute (2 weeks to 3 months). Paresthesias (9/19) and pain (5/19) were the most frequent symptoms. Sensorimotor neuropathy was the most frequent phenotype (8/19). An onconeural antibody was identified in 14 patients (73.7%). Primary tumors were found in 9 patients (47.3%). Lung cancer was the most frequent tumor (33.3%).
The latency between PN and the diagnosis of tumors was 27.9 months (SD 18.18). Twelve patients (63.2%) were treated with immunotherapy. In two cases a clinically significant improvement was evidenced (10.5%), 68.4% of patients (13/19) remained stable, 4 patients worsened their symptoms (21%) and three patients died (15%).
Conclusions:
Sensory complaints and a subacute presentation were the most frequent in the majority of cases. The most common phenotype is sensorimotor neuropathy, so this entity should be suspected in patients with these characteristics after proper exclusion of other more frequent causes.