A Case of Paraneoplastic Demyelinating Motor Polyneuropathy

Peripheral neuropathy is commonly accompanied by cancer but demyelinating ones are not commonly reported. We report the clinical, neurophysiological, and biological characteristics of an 82-year-old patient who presented with a demyelinating motor neuropathy and high titre of anti-ganglioside antibodies associated with oesophageal cancer. The neurological course worsened rapidly despite immunotherapy, leading to a bedridden status. We propose to suspect a paraneoplastic origin in older patients or when the clinical course progresses rapidly within a few weeks or months

Malignancy in Guillain-Barré syndrome:A twelve-year single-center study

The relationship between Guillain-Barré syndrome (GBS) and malignancy is uncertain. We retrospectively analyzed data of 118 consecutive patients admitted with GBS from Birmingham, U.K. (2001 − 2012). We calculated relative cancer risk using different definitions and determined characteristics of malignancy-associated GBS. Malignancy was globally commoner in our GBS cohort compared to the general population (odds ratio: 2.08; CI: 1.06–3.71; p = 0.036). However, this was unconfirmed if paraneoplastic criteria were applied. GBS patients with cancer were significantly more likely to be older (p = 0.043), hyponatremic (p = 0.037) and demonstrate more axonal loss (p < 0.05). Cerebrospinal fluid (CSF) protein levels were lower in the malignancy group (p = 0.002) and neurological improvement less likely (p = 0.023). In-patient mortality was significantly higher in patients with malignancy (p < 0.01). We conclude global cancer risk is higher in GBS than in the general population, although definition-dependent. Malignancy requires consideration in elderly, hyponatremic subjects with normal CSF protein, severe axonal loss, who fail to improve post-treatment