The CNS Paraneoplastic Syndrome: A Review of the Pathogenesis, Types, Manifestations and Diagnosis

Abstract

Paraneoplastic Neurological Syndromes (PNS) are a rare spectrum of non-metastatic manifestations likely secondary to T-cell or auto-antibodies induced neuronal dysfunction or cell death and are mostly associated with soft tissue cancers. PNS arises from either the cell membrane binding site of antineuronal antibodies causing protein dysfunction or from the antibodies that bind it to the intracellular antigens leading to necrosis of the cell. The neurological paraneoplastic phenotypes are numerous. Encephalomyelitis, acute cerebellar degeneration, Limbic Meningoencephalitis (LE), and dorsal sensory neuropathy are a few of them worth discussing. Specific antibodies are sometimes associated with specific underpinning tumor types. Screening for malignancy is important for all patients suspected of paraneoplastic neurological manifestations. Urgent biotherapy initiation is important in treating patients with the paraneoplastic neurological syndrome. It is more effective in cell surface antibodies than intracellular antibodies, as it removes the inexplicit tumor. This review article aims to elucidate the possible etiopathogenic patterns of different types of PNS.