Neurológia pre prax 5/2013

Peripheral neuropathies in malignancies

Peripheral neuropathies in a context of systemic malignancy may have a different cause and can manifest in various stages of development of malignancy. They can be a direct effect of the primary malignancy, a paraneoplastic syndrome, or a treatment complication. Malignant neoplasms may infiltrate or compress peripheral nerves or roots, causing various sensory and motor symptoms. Paraneoplastic syndromes are rare, but they can precede a manifestation of the cancer itself. The most common is subacute sensory neuronopathy, sensorimotor neuropathies are less common. Neuropathies may also be an indirect consequence of a dysimmune mechanism, for instance in patients with lymphomas or vasculitis. Peripheral neurotoxicity is a side effect of many chemotherapeutic agents and can affect the nerve fibers or the neuronal bodies. This side effect frequently represents one of their dose-limiting factors in cancer treatment. Both brachial and lumbosacral plexopathies may develop as a complication of radiotherapy.

Keywords: peripheral neuropathy, neurolymphomatosis, paraneoplastic neuropathy, chemotherapy, neurotoxicity, radiotherapy.