Paraneoplastic neurological syndrome in the course of breast cancer

Abstract

Paraneoplastic neurological syndromes (PNS) are a group of rarely observed disorders, accompanying about 1% of cancer diseases. They have a typically aggressive course, leading to profound and essentially irreversible disability. The pathogenic cause behind PNS is damage of the nervous system structures as a consequence of the body’s immunological reaction induced by cancer. Onconeural antibodies generated as part of the reaction target the tumour tissues, but also the regular nervous tissue recognized as antigens. Presence of onconeural antibodies reveals a 50–60% sensitivity and 100% specificity in diagnosing PNS. Imaging and laboratory tests have a limited impact on diagnosis. What is crucial is the analysis of clinical systems following Graus’s criteria (elaborated in 2004). In the case presented here, the patient underwent treatment in many neurological departments due to the symptoms of progressive damage of the nervous system. She was eventually diagnosed with the stiff person syndrome related to breast cancer. In spite of the treatment, including an efficacious oncological therapy, the severe neurological deficit resulted in serious motor disability.