Diagnosis and treatment of paraneoplastic neurological disorders

In about two thirds of cases, patients with paraneoplastic
neurological disorders present to the neurologist without a known
tumor. Due to the ongoing immune response, this tumor tends to stay
biologically relatively benign, and therefore difficult to
diagnose. In patients with a known tumor, the neurological symptoms
often precede a tumor recurrence. In both scenarios, anti-neuronal
antibodies are an invaluable diagnostic help to the clinician, and
may be supplemented by other diagnostic tests such as MRI, CSF, and
electrophysiology. Tumor therapy remains the mainstay of
therapeutic options, although early immune therapy must be started
in parallel. It is hoped that the recent fundamental advances in
understanding the autoimmune pathology of these disorders,
especially the role of cytotoxic T cells, will eventually lead to
more effective treatment options.