Multiple Neurologic Paraneoplastic Syndromes

Abstract

Neoplasm can affect the nervous system both by direct invasion or by remote effect. Established neurollogic paraneoplastic syndromes include involvement of muscle, neuromuscular junction, peripheral nerve, spinal cord, cerebellum, brainstem, and cerebrum.^1-5 Paraneoplastic syndromes may precede the identification of the neoplasm; their recognition can be important in diagnosing the underlying disorder. We report the combination of three distinct neurologic paraneoplastic syndromes associated with a pulmonary neoplasm, each of which was symptomatic and incapacitating. REPORT OF A CASE In January 1976, a 62-year-old man experienced generalized weakness and distal paresthesias rapidly during several days. Medical history was unremarkable and he had a 40 pack-year smoking history. He was hospitalized ten weeks later; at that time, all extremities were moderately weak, with greatest weakness in the distal muscles and affecting the legs more than arms. There was moderate distal sensory loss. Muscle stretch reflexes were absent. No pathologic reflexes were noted.