From the Guidelines
Paraneoplastic encephalomyelitis associated with anti-Hu antibodies is the paraneoplastic syndrome that can cause parkinsonism and dysphagia. This condition is often associated with small cell lung cancer (SCLC) 1. The syndrome develops when antibodies target neuronal RNA-binding proteins, disrupting normal neurotransmission and resulting in multiple neurologic deficits, including limbic encephalitis, brainstem encephalitis, cerebellar degeneration, opsoclonus myoclonus, myelopathy, cranial nerve palsy, and sensory neuropathy 1. Some key points to consider include:
- The clinical manifestation of paraneoplastic encephalomyelitis may include parkinsonism and dysphagia, among other neurological symptoms 1.
- Patients with paraneoplastic encephalomyelitis often present with rapidly progressive neurological symptoms, and early diagnosis and treatment are crucial for improving outcomes 1.
- Treatment involves immunotherapy and removal of any underlying tumor, and may also include symptomatic management of neurological symptoms such as dysphagia and parkinsonism 1.
- Dysphagia is a common symptom in various neurological disorders, including Parkinson's disease, and can have significant impacts on nutrition and quality of life 1. However, in the context of paraneoplastic syndromes, anti-Hu associated encephalomyelitis is a key consideration for patients presenting with parkinsonism and dysphagia 1.
From the Research
Paraneoplastic Syndromes Causing Parkinsonism and Dysphagia
- Paraneoplastic brainstem encephalitis is a rare condition that can cause a variety of symptoms, including parkinsonism and dysphagia 2.
- This condition is often associated with specific antineuronal autoantibodies, such as anti-Hu, anti-Ri, and anti-Ma2, and can be linked to various types of cancer, including lung and testicular cancer 2.
- Anti-Hu-associated brainstem encephalitis, in particular, has been reported to cause central hypoventilation, and is typically associated with small-cell lung cancer or other neuroendocrine tumors 3, 4.
- While the exact mechanisms of paraneoplastic neurological disorders are not fully understood, research suggests that they result from an immune response against tumor antigens that also targets the nervous system 4, 5.
- Diagnosis of paraneoplastic syndromes can be challenging, but the presence of specific antibodies, such as anti-Hu or anti-Ma2, can support the diagnosis and lead to the identification of an underlying tumor 5, 6.
- Treatment of the underlying tumor is often the most effective way to manage paraneoplastic syndromes, although immunotherapy may also be beneficial in some cases 5, 2.