How To Diagnose Paraneoplastic Syndrome & What Is The Best Medicine For It?

Paraneoplastic syndrome is a cluster of rare diseases that affects some people who are suffering from cancer. It may affect various systems like nervous and hormonal system, joints, blood, and skin.⁽¹⁾

Paraneoplastic syndromes can be diagnosed with the help of a physical examination carried out by your doctor and some other tests like blood tests, imaging tests, and spinal tap.⁽²⁾

Physical Examination: The consultant will perform a detailed physical as well as a neurological examination. He will check for your-

• Reflex actions
• Strength of muscles
• Muscle tone
• Sensitivity to touch
• Visual and audio capabilities
• Coordination
• Balance
• Memory
• Mood etc.⁽²⁾

The tests that he may ask for are-

Blood tests for Paraneoplastic syndrome may be performed for various reasons like identifying the antibodies associated with your syndrome, identifying the infection, a hormonal disorder, metabolic disorder, etc. these conditions can also cause your symptoms and hence, must be ruled out⁽²⁾

• Also known as a spinal tap, this procedure for Paraneoplastic syndrome is done to get a sample of your CSF. CSF cushions your spinal cord and brain.
• A neurologist removes a little quantity of your CSF from your lower spine and sends it for laboratory examination
• Analysis of CSF may sometime reveal the presence of antibodies, whereas they might be absent in the blood tests

If there is a presence of these antibodies in both blood and CSF, it is strongly suggestive of activation of the immune system, and thus justifies your signs and symptoms ⁽²⁾

• Computerized tomography or a CT scan is an x-ray technology, which produces cross-sectional images of tissues in the body
• This test to diagnose paraneoplastic syndrome may be helpful in finding and locating a tumor, which might be the underlying factor responsible for the neurological symptoms⁽²⁾

• Magnetic resonance imaging or MRI is a scanning technique in which, a magnetic field and radio frequency waves are used to get 3D, cross-sectional images of the tissues in your body
• MRI is similarly useful as CT scan in establishing and confirming a diagnosis of the paraneoplastic syndrome⁽²⁾

• Positron emission tomography or PET scan is an imaging method for Paraneoplastic syndrome in which radioactive substances are introduced in your body and cross-sectional images are produced
• This scanning method can be useful in identifying and locating a tumor in the body, measure tissue metabolism, display blood circulation and locate and identify abnormalities of the brain⁽²⁾

• This is a combination of PET and CT scan which helps in the detection of small cancers, which is very common in people with paraneoplastic syndromes⁽²⁾
• If these tests do not reveal any tumor or cause, there is still a chance that the condition might be due to some extremely small tumor which is difficult to locate. The tumor may be getting a strong response from the immune system, which is responsible for keeping the tumor so small. A repeat follow- up and tests might be essential in such conditions until the cause is identified⁽²⁾

There is no best medicine as there is no cure for paraneoplastic syndromes at present. However, the treatment aims at relieving the symptoms and improves the quality of life. Also, the treatment can help in arresting further damage to the nervous system, or at least delay the onset of other conditions.

Most times, the treatment includes treating, underlying cancer. It also aims at suppressing the immune system⁽²⁾

The treatment will largely depend upon the paraneoplastic syndrome that you are suffering from and may include-

• Corticosteroids
• Immunosuppressants

• Anti-convulsants
• Nerve to muscle transmission enhancers

• Plasmapheresis
• Intravenous immunoglobulin

• Occupational therapy like speech therapy
• Physical therapy

The paraneoplastic syndrome does not have a cure at present. The treatment aims at treating the underlying cancer and reducing symptoms.

References:

Also Read:

• Paraneoplastic Syndrome: Causes, Symptoms, Treatment, Pathogenesis, Types