Managing Paraneoplastic Neurological Disorders论文.docVIP

　　Managing Paraneoplastic Neurological Disorders论文 .freelitt 【关键词】 Paraneoplastic,neurological,syndromes, #8226;,Cancer, #8226;,Autoimmunity, #8226;,Autoantibodies, #8226;,Onconeural,antigens LEARNING OBJECTIVES After pleting this course,.freelmune pathogenesis of paraneoplastic neurological syndromes. Explain the clinical value of paraneoplastic antibody detection. Describe the general treatment approach to paraneoplastic neurological syndromes. ABSTRACT Paraneoplastic neurological syndromes (PNS) are remote effects of cancer that are not caused by invasion of the tumor or its metastases. Immunologic factors appear important in the pathogenesis of PNS because antineuronal autoantibodies and T-cell responses against nervous system antigens have been defined for many of these disorders. The immunologic response is elicited by the ectopic expression of neuronal antigens by the tumor. Expression of these so-called onconeural antigens is limited to the tumor and the nervous system and sometimes also the testis. At the time of presentation of the neurological symptoms, most patients have not yet been diagnosed ely helpful in diagnosing an othere as paraneoplastic. In addition, the paraneoplastic antibodies may also direct the search for an underlying neoplasm. On the other hand, in patients knoay herald recurrence of the tumor or a second tumor. The number of paraneoplastic antibodies is still groe, the type of antibody, and the presence or absence of cancer, patients are classified as having a definite or possible PNS. Despite the presumed autoimmune etiology of PNS, the results of various forms of immunotherapy have been disappointing, e exceptions. Rapid detection and immediate treatment of the underlying tumor appears to offer the best chance of stabilizing the patient and preventing further neurological deterioration. INTRODUCTION Paraneoplastic neurological syndromes (PNS) are remote effects of cancer that are, by definition, caused neither by invas