Paraneoplastic Neurological Disorder in Nasopharyngeal Carcinoma

| Posted in: Science

Journal name: The Malaysian Journal of Medical Sciences
Original article title: Paraneoplastic Neurological Disorder in Nasopharyngeal Carcinoma
The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access journal published online at least six times a year. It covers all aspects of medical sciences and prioritizes high-quality research.
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Original source:

This page is merely a summary which is automatically generated hence you should visit the source to read the original article which includes the author, publication date, notes and references.

Author:

Sze Yin Ng, Min Han Kongg, Mohd Razif Mohamad Yunus


The Malaysian Journal of Medical Sciences:

(A peer-reviewed, open-access journal)

Full text available for: Paraneoplastic Neurological Disorder in Nasopharyngeal Carcinoma

Year: 2017 | Doi: 10.21315/mjms2017.24.1.12

Copyright (license): CC BY 4.0


Download the PDF file of the original publication


Summary of article contents:

Introduction

Paraneoplastic neurological disorder (PND) is a rare condition arising from immune cross-reactivity between tumor cells and the normal nervous system, where "onconeural" antibodies target healthy neural tissue. It can manifest weeks to months before or after cancer diagnosis and is particularly associated with nasopharyngeal carcinoma (NPC). Chronic conditions like these are often underreported but can lead to significant neurological symptoms, emphasizing the need for collaborative awareness among otolaryngologists, oncologists, and neurologists for timely diagnosis and intervention.

The Impact of PND in Nasopharyngeal Carcinoma

A case study of a 76-year-old man diagnosed with NPC underscores the complexities of PND. Despite the absence of spinal or leptomeningeal metastasis, the patient presented with peripheral neuropathy, urinary and bowel incontinence, and significant lower limb weakness. Comprehensive examinations, including imaging and nerve conduction studies, ultimately led to the diagnosis of PND, as other potential causes such as infections or metastasis were excluded. Though the patient received palliative radiotherapy, he did not follow up, highlighting the challenges in managing patients with such conditions and the necessity of exploring various treatment options.

Conclusion

PND represents a diagnostic challenge, especially in patients with underlying malignancies displaying neurological dysfunction. The rarity of PND necessitates a thorough exclusion of other causes before reaching a definitive diagnosis. Importantly, treatment efforts should focus on addressing the underlying cancer, as this is crucial for improving neurological outcomes. Increased awareness and collaboration among healthcare professionals can aid in better diagnosis and treatment for patients facing the devastating effects of PND associated with cancers like NPC, ultimately enhancing patient care and survival rates.

FAQ section (important questions/answers):

What is paraneoplastic neurological disorder (PND)?

Paraneoplastic neurological disorder (PND) is an immune-mediated condition where antibodies mistakenly attack normal nervous tissue due to antigenic similarity with tumor cells, often presenting alongside malignancies like nasopharyngeal carcinoma.

How is PND related to nasopharyngeal carcinoma?

PND can occur in patients with nasopharyngeal carcinoma (NPC), where the immune system reacts to onconeural antigens, potentially causing neurological dysfunction and requiring awareness from oncologists and neurologists for effective diagnosis and treatment.

What are the symptoms of PND in this case study?

The case study describes an elderly patient experiencing progressive lower limb weakness, numbness, and urinary and bowel incontinence, indicative of PND, occurring after being diagnosed with nasopharyngeal carcinoma.

What treatments are available for PND associated with cancer?

Treatment strategies for PND include managing the underlying malignancy, with immunomodulatory therapies sometimes used, but effectiveness varies. In this case, the patient received palliative radiotherapy leading to slight neurological improvement.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Paraneoplastic Neurological Disorder in Nasopharyngeal Carcinoma”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Radiotherapy:
Radiotherapy refers to a medical treatment that uses high doses of radiation to kill cancer cells and shrink tumors. It is often employed in cases of nasopharyngeal carcinoma to control tumor growth and alleviate symptoms. Radiotherapy can improve neurological functions in patients with paraneoplastic syndromes by targeting the underlying malignancy.

2) Cancer:
Cancer is a disease characterized by the uncontrolled growth and spread of abnormal cells. In the context of the report, nasopharyngeal carcinoma is highlighted as a malignancy associated with multiple paraneoplastic syndromes, including neurological disorders. Understanding the relationship between cancer and paraneoplastic syndromes is crucial for diagnosis and treatment.

3) Disease:
Disease refers to a pathological condition affecting the body that disrupts normal functioning. In the context of this report, paraneoplastic neurological disorder (PND) exemplifies a rare disease resulting from immune responses related to cancer. Identifying such diseases is critical for proper medical intervention and management.

4) Silver:
Silver refers to a specific author mentioned in the references, specifically in the context of paraneoplastic syndromes in nasopharyngeal cancer. The mention of authors is relevant as it lends credibility to the findings and recommendations made in the article, especially in a research context where credible sources are essential.

5) Study (Studying):
Study entails investigating or examining a specific subject to derive conclusions or generate knowledge. In this report, studies referenced detail the varieties and implications of paraneoplastic syndromes, thereby reinforcing the need for ongoing research to better understand these conditions and their association with cancers like nasopharyngeal carcinoma.

6) Ras (Rash):
Rash is a skin manifestation that can be a symptom of certain paraneoplastic syndromes, such as dermatomyositis. The presence of a rash can indicate an autoimmune response to a malignancy. Recognizing a rash can assist healthcare providers in diagnosing underlying cancers associated with paraneoplastic syndromes.

7) Pain:
Pain is a subjective, unpleasant sensory experience often associated with injury or disease. In oncology, patients may experience pain due to primary tumors, metastasis, or treatment side effects. Understanding pain mechanisms is crucial for holistic cancer care and can influence treatment approaches, including medication and therapy choices to alleviate symptoms.

8) Chan:
Chan refers to a specific author cited in the references who contributed to the discourse surrounding paraneoplastic syndromes and their association with nasopharyngeal carcinoma. Citing reputable authors enriches the research credibility and presents readers with established viewpoints and findings from recognized experts in the field.

9) Chemotherapy:
Chemotherapy involves the use of drugs to kill or inhibit the growth of cancer cells. It is a common treatment modality for various cancers, including nasopharyngeal carcinoma. Awareness of chemotherapy’s potential side effects, including impacts on neurological status, is critical in managing patient care and expectations during and after treatment.

10) Discussion:
Discussion is a critical section in academic and clinical reports where findings, implications, and future directions are shared. In this report, the discussion addresses clinical observations and the complexities of diagnosing PND in the context of nasopharyngeal carcinoma. It highlights the need for a nuanced understanding of these conditions in patient care.

11) Similarity:
Similarity refers to the resemblance between the antigens on tumor cells and those on neural tissues, leading to autoimmune conditions like paraneoplastic syndromes. Recognizing this similarity is pivotal for understanding the underlying mechanisms for PND, thereby guiding clinicians towards appropriate diagnostic and treatment strategies in affected patients.

12) Knowledge:
Knowledge refers to the awareness and understanding of subjects that empower healthcare providers to make informed decisions. Clinicians’ knowledge on paraneoplastic syndromes and their associations with cancer is essential for timely diagnosis and management, ultimately affecting patient outcomes and the quality of care delivered.

13) Toxicity:
Toxicity concerns the degree to which a substance can harm an organism. In oncology, treatment-related toxicity can lead to serious complications in patients with cancer. Understanding toxicity from treatments like chemotherapy and radiotherapy is vital for optimizing patient care, minimizing side effects, and ensuring better overall patient management.

14) Swelling:
Swelling, or edema, often arises from inflammation or tumor growth, leading to increased fluid accumulation in tissues. In oncology, swelling can signify lymph node involvement or metastasis. Recognizing and assessing swelling is crucial for monitoring disease progression and response to treatment in cancer patients.

15) Fever:
Fever is a common response of the immune system to infection or malignancy. It can be a symptom of paraneoplastic syndromes or neoplastic processes. Monitoring fever in cancer patients is essential as it may indicate complications or the presence of an underlying infection or other systemic responses.

16) Blood:
Blood is critical for transporting nutrients, oxygen, and immune cells throughout the body. In the context of cancer, blood tests reveal important information regarding patient health, tumor markers, and organ function. Understanding blood-related parameters can guide diagnosis, treatment decisions, and responses to cancer therapies.

17) Horn:
Horn likely refers to a segment of the spinal anatomy, which can be relevant in discussing lower motor neuron lesions. Understanding the anatomy, including the anterior horn of the spinal cord, aids in the diagnosis of neurological disorders, allowing healthcare professionals to better assess motor function and disease impact.

18) Post:
Post in a medical context generally refers to after a certain event or treatment. Understanding post-treatment effects is crucial for managing patient expectations and monitoring recovery. Assessing symptoms or changes in condition after treatments like radiotherapy helps healthcare providers refine ongoing management strategies for their patients.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Paraneoplastic Neurological Disorder in Nasopharyngeal Carcinoma’. Further sources in the context of Science might help you critically compare this page with similair documents:

Radiotherapy, Clinical examination, Nervous system, Central nervous system, Clinical feature, Spinal Cord, Conflict of interest, Lower limb, World Health Organisation, Neurological disorder, Sensory Neuropathy, Peripheral neuropathy, Magnetic resonance imaging, Peripheral Nervous System, Nerve conduction study, Spinal cord compression, Urinary Incontinence, Lower motor neuron, Lower limb weakness, Muscle biopsy, Tumor cell, Chronic obstructive airway disease, Neurological Dysfunction, Motor neuron, Dermatomyositis, Accurate diagnosis, Neurological function, Lumbar puncture, Diagnosis of exclusion, Tumour cells, Paraneoplastic syndrome, Motor neuropathy, Nasopharyngeal carcinoma, Authors contribution.

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