Acute peripheral neuropathies are seldom described in association with malignant disease and their demyelinating nature is not clear. Carcinomas from various tissues and lymphomas are reported in association with paraneoplastic sensprimotor neuropathies. In our knowledge there is no reported association with mesothelioma. We describe the case of a 74-year-old woman , who had a surgical intervention for a pleural mesothelioma in '94. No chemotherapy nor radiotherapy were performed after surgery. She had good health until September '96, when she presented with rapidly developing weakness and paresthesias in the lower limbs, that after few days extended to upper limbs. She could walk only with assistance and was unable to climb stairs and remained unchanged in this situation for 4 months. An EMG, performed during this period, showed relevant slowing of motor and sensory conduction velocities, suggesting the demyelinating nature of the process WP observed the patient in March '97. In the month preceding the admission she had had spontaneous improvement of lower limb motor performances with persistence of distal paresthesias. At clinical examination on admission we found only a mild weakness of the lower limb-girdle with normal sensibility and presence of tendon reflexes. The EMG confirmed a marked reduction of motor and sensory conduction velocities. A chest radiography showed recurrence of the pleural neoplasm. Search for anti-neuronal autoantibodies is in progress. The relevance of conduction velocity reduction (20 m/s in the peroneal nerve) and the spontaneous improvement strongly suggest a diagnosis of Guillain-Barré syndrome. Immunohistochemical examination was negative for anti-neuronal antibodies. Relapse of the tumor was subsequently disclosed, supporting paraneoplastic origine of the neuropathy.
|Number of pages||1|
|Journal||Italian Journal of Neurological Sciences|
|Publication status||Published - 1997|
ASJC Scopus subject areas
- Clinical Neurology