Motor Neurone Disease as a Mainfestation of Neoplasm

Brain, Lord; Croft, P. B.; Wilkinson, Marcia

doi:10.1093/brain/88.3.479

Cited by 90 publications

(21 citation statements)

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“…The neurological illness in these patients also differs both clinically and pathologically from "carcinomatous amyotrophic lateral sclerosis" (ALS) as described by Norris and Engel [18] and Brain et a1 [2]. This latter disorder was inexorably progressive and was characterized by prominent upper as well as lower motor neuron signs; it was clinically and pathologically indistinguishable from the sporadic form of ALS.…”

Section: Different Id Diagnosismentioning

confidence: 74%

Subacute motor neuronopathy: A Remote effect of lymphoma

Schold

Cho

Somasundaram

et al. 1979

Annals of Neurology

165

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Ten patients developed a subacute lower motor neuron syndrome as a remote effect of Hodgkin's disease or other lymphoma. The illness usually followed a benign course independent of the activity of the underlying neoplasm. Seven of the patients improved spontaneously, and 3 became neurologically normal. Two patients died of intercurrent infections related to immunosuppression. Neuropathological examination of these 2 patients and 3 previously reported cases showed prominent neuronal degeneration restricted to the anterior horns of the spinal cord and mild posterior column demyelination. Demyelination was also present in the anterior roots of our autopsied patients and was accompanied by large, hyperchromatic Schwann cells. The cause of the illness is obscure, but both radiation therapy and opportunistic infection may be contributing factors. Attempts at virus isolation have been unsuccessful. The syndrome should be distinguished from the more common direct effects of lymphoma on the nervous system, since its identification spares the patient additional, potentially harmful therapy.

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Section: Different Id Diagnosismentioning

confidence: 74%

Subacute motor neuronopathy: A Remote effect of lymphoma

Schold

Cho

Somasundaram

et al. 1979

Annals of Neurology

165

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“…None of the seven patients who underwent treatment after ALS onset showed an amelioration of the MND symptoms, and two of them dramatically worsened. An amelioration of motor neuron syndrome after the oncological therapy has been reported in rare cases [3,5,9,11,19], but only two of those patients had a pure ALS. Pure ALS, even in presence of anti-Hu antibodies, does not usually benefit from the oncological treatment [11,26].…”

Section: Discussionmentioning

confidence: 99%

“…To date there are no clues about the etiopathogenesis of this disorder, but in some patients harboring both ALS and cancer a paraneoplastic origin of the former has been suggested [3,19]. Indeed, most authors agree that motor neuron disease (MND) may represent an aspect of paraneoplastic encephalomyelitis [8].…”

Section: Introductionmentioning

confidence: 99%

“…However, it is still under discussion whether pure ALS occurring in cancer patients is paraneoplastic. Remission or improvement in neurological signs after treatment of a coexistent neoplasm and the presence of serum antibodies reacting with neuronal antigens in some of these patients suggest a relationship between cancer and motor neuron involvement [3,9,10,11,19,25,26]. Nonetheless, a significant association between ALS and cancer has not been supported by the epidemiological surveys [2,6,14,16,17,21,29].…”

Section: Introductionmentioning

confidence: 99%

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Patients with amyotrophic lateral sclerosis and cancer do not differ clinically from patients with sporadic amyotrophic lateral sclerosis

Vigliani¹,

Polo²,

Chiò³

et al. 2000

Journal of Neurology

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We examined whether patients with both amyotrophic lateral sclerosis (ALS) and cancer differ from classical ALS patients, and whether motor neuron disease responds to oncological therapy. We analyzed clinical and immunological features of 14 patients (9 men, 5 women; mean age 65.3 years) with pure/definite ALS and cancer. Patients with solid tumor cancer and definite ALS were selected according to the E1 Escorial criteria; cases with ALS plus were excluded. Four patients had breast cancer, three lung adenocarcinoma, and three bowel tumor; hepatocarcinoma, kidney cancer, and mesothelioma were observed in one case each, and in one patient the primary tumor was unidentified. Patients' sera were examined for antinervous system antibodies by means of immunohistochemistry and western blot analysis. Of five patients who underwent surgical therapy, two worsened during the procedure, while the other three had no benefit. The remaining two patients did not improve after chemotherapy and radiotherapy. In none of our cases did the oncological disease progress. Death was a consequence of ALS in all eight patients who died. Median survival was 18 months and did not differ from that of 28 ALS patients matched for age, sex, and onset features (bulbar or spinal). Anti-nervous system antibodies were never detected. We conclude that our group of pure ALS patients with cancer do not significantly differ from patients with classical ALS. They usually die as a consequence of the motor neuron syndrome in the absence of cancer progression. To date we have not observed any response of ALS to antitumor therapy.

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“…Myelopathy was described in Hodgkin's disease [6] and in lymphosarcoma [12], Motor neurone disease was described in Hodgkin's disease [10] and in reticulum cell sarcoma [3], Peripheral neuropathy was described in Hodgkin's disease [6] and in reticulum cell sarcoma [10], In their survey, C urrie et ai. [4] found that 6 out of 210 patients with Hodgkin's disease had overt neurological disorders; 1 had progressive multifocal leucoencephalopathy, 2 poly myositis and 3 had peripheral neuropathy.…”

Section: Resultsmentioning

confidence: 99%

Sub-Clinical Involvement of Peripheral Nerves in Hodgkin’s Disease

Chaco¹

1973

Oncology

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A wide variety of non-metastatic neurological syndromes occur in association with malignant lymphoma. 20 patients with Hodgkin’s disease and 20 matched healthy subjects underwent motor nerve conduction velocity testing of the right ulnar and left median nerves. The testing was carried out 3–5 days after confirmation of the diagnosis. The clinical neurological examination was normal in all the patients. In 6 patients, pathological motor nerve conduction velocity rates were found. The results indicate a high frequency of sub-clinical peripheral neuropathy in Hodgkin’s disease even during the very early stages of the disease.

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Motor Neurone Disease as a Mainfestation of Neoplasm

Cited by 90 publications

References 0 publications

Subacute motor neuronopathy: A Remote effect of lymphoma

Subacute motor neuronopathy: A Remote effect of lymphoma

Patients with amyotrophic lateral sclerosis and cancer do not differ clinically from patients with sporadic amyotrophic lateral sclerosis

Sub-Clinical Involvement of Peripheral Nerves in Hodgkin’s Disease

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