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P.06 A paraneoplastic peripheral demyelinating motor neuropathy: a case report
  1. S Dharia1,
  2. K M Gormley2
  1. 1Plymouth Hospitals NHS trust, Plymouth, UK
  2. 2Royal Devon and Exeter Hospital Foundation Trust, Exeter, UK

Abstract

Background Paraneoplastic neurological syndromes are usually associated with small cell lung cancer, gynaecological, lymphomas and renal cell carcinomas. A few studies report the association of neurological syndromes with squamous cell carcinoma of lung (SCC), the majority being sensory neuropathies. We describe a patient with a demyelinating motor polyneuropathy associated with a lung SCC.

Case Report A 43-year-old male presented with limb weakness. On examination he was areflexic with predominantly proximal weakness of the lower limbs. Neurophysiology showed a demyelinating motor polyneuropathy. Cerebrospinal fluid examination and chest x-ray were normal. Antineuronal and antiganglioside antibody screens were negative. Repeated courses of intravenous immunoglobulins and plasmapheresis did not stop progression to complete paresis in all four limbs with preserved sensation and cranial nerve function. Whole body Positron Emission Tomography scanning showed avid mediastinal lymphadenopathy and SCC of lung was diagnosed at biopsy. Radiotherapy produced clearance of the malignancy which resulted in a dramatic recovery. He regained limb power such that he now walks short distances unaided and has functional use of the arms.

Conclusion This is the first described case of antibody negative demyelinating peripheral motor neuropathy in association with SCC of lung. A thorough search for malignancy should be undertaken in demyelinating polyneuropathies.

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