Clinical data for the seven patients with anti-onconeural antibodies (group I). Delay indicates the interval between the onset of neurological symptoms and cancer diagnosis. In every case, the neuropathy preceded the discovery of the tumour. The revised Rankin score is used to estimate the maximal deficit reached by the patients
| No | Sex/age | Delay (months) | Clinical manifestations | Rankin | Course | Electrophysiology |
|---|---|---|---|---|---|---|
| 1 | M/56 | 23 | Sensory > motor symmetric in four limbs ataxia. Central nystagmus. Hearing loss. Pain. Depressed tendon reflexes | 4 | Progressive | Reduced or absent SAP. Normal SCV. Reduced MAP, normal MCV. Reduced interferential pattern |
| 2 | M/56 | 9 | Sensory symmetric in four limbs. Pain. Ataxia. Depressed tendon reflexes nystagmus, temporal lobe epilepsy | 4 | Progressive | Reduced SAP. Significantly reduced SCV (3.4μV and 29 m/s in ulnar nerves). Almost normal MCV |
| 3 | M/61 | 8 | Sensory > motor deficit asymmetric in lower limbs. Areflexia. Pain. Digestive obstruction | 3 | Subacute | Absent SAP. Mildly reduced MCV in lower limbs with TD. Reduced interferential pattern |
| 4 | M/73 | 8 | Sensory > motor asymmetric in lower limbs. Areflexia. Cerebellar ataxia | 3 | Subacute | Absent SAP. Mildly reduced SCV. Mild reduction of MAP and MCV reduced interferential pattern |
| 5 | M/50 | 2 | Multifocal sensory and painful. Reduced tendon reflex. Orthostatic hypotension | 2 | Subacute | Absent or reduced SAP. Normal SCV normal MCV. Normal electromyography |
| 6 | M/65 | 8 | Asymmetric sensory > motor deficit in four limbs. Pain. Ataxia. Memory loss | 4 | Progressive | Reduced or absent SAP. Mildly reduced MAP and MCV. Prolonged F waves. Temporal dispersion in tibial nerves Reduced interferential pattern |
| 7 | F/62 | 12 | Sensory-motor deficit and areflexia in lower limbs. Cerebellar ataxia orthostatic hypotension | 4 | Progressive | Reduced SAP and SCV. Reduced MAP. Mildly reduced MCV. Reduced interferential pattern |
CSF | Tumour | Pathology | Antibody |
|---|---|---|---|
| 2.0 g/l 54 lympho | SCLC | Nerve biopsy, fibre loss, axonal degeneration | Anti-Hu |
| 1.14 g/l 43 lympho | SCLC | Nerve biopsy, fibre loss, axonal degeneration | Anti-Hu |
| 0.42 g/l 1 lympho | SCLC | Nerve biopsy, fibre loss | Anti-Hu |
| 0.78 g/l 1 lympho | Small cell carinoma prostate | Nerve biopsy, axonal degeneration | Anti-Hu |
| 1.2 g/l 1 lympho | SCLC | ND | Anti-Hu |
| 1.62 g/l 52 lympho | SCLC | Necropsy: mild ganglionitis, fibre loss in distal nerves. Demyelination, onion bulbs endoneurial lymphocytes | Anti-Hu |
| 0.77 g/l 17 lympho | Undifferentiated carinoma mediastinum | Necropsy: normal sensory ganglia and spinal cord. Fibre loss demyelinated fibers | Anti-CV2 |
Course corresponds to the onset of neurological symptoms: acute, <1 month; subacute 1-2 months; progressive, >2 months; CSF=number of lymphocytes/mm3; ND=not done; SCLC=small cell lung carcinoma; SAP=sensory action potential; SCV=sensory conduction velocities; MAP=motor action potentials; MCV= motor conduction velocities.