β Scribed by Robin Grant; Francesc Graus
No coin nor oath required. For personal study only.
Paraneoplastic movement disorders are rare autoimmune nonmetastatic complications of cancer. Common paraneoplastic movement disorders include cerebellar syndrome, opsoclonus myoclonus, basal ganglia disorders, stiff person syndrome, and neuromyotonia. Syndromes usually present before cancer diagnosis and are commonly associated with one or more serum antibodies. Increasing numbers of antibodies have been identified (Hu, Yo, Ri, CV2, amphiphysin, Ma, Ta, Tr, NMDA, mGluR1, PCA2, ANNAβ3, VGCCA). Antibodies are highly correlated with the likelihood of an underlying cancer and are closely associated with certain tumors. Clinical clues to paraneoplastic aetiology include speed of onset, severity, speed of progression, resistance to treatment, and more widespread neurological signs than one would expect from nonparaneoplastic aetiologies. Cancer should be sought in those with classical presentations and those with possible presentations who have paraneoplastic antibodies. If no tumor is found on initial investigation, interval screening is advisable. The most common associated cancers found are small cell lung cancer, breast, gynaecological, testicular, lymphoma, and thymoma. Early identification and treatment sometimes leads to neurological improvement and may improve cancer prognosis. Prognosis is dependent on the tumor type and its likely response to treatment. Β© 2009 Movement Disorder Society
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## Abstract The paraneoplastic autoantibody, collapsin responseβmediator protein (CRMP)β5 immunoglobulin G (IgG), is specific for neuronal cytoplasmic CRMPβ5, and is usually associated with smallβcell lung carcinoma or thymoma. We report on details of a movement disorder that followed antiβBβcell t
The choice of therapy for dystonia is guided by the anatomic distribution, age of the patient, and personal experience of the clinician. Idiopathic torsion dystonia can be ameliorated with symptomatic therapy, but secondary dystonias may require specific, etiology-targeted, therapeutic suategies. Al