CARCINOMA AND THE PERIPHERAL NERVOUS-SYSTEM

An underlying carcinoma is an important differential diagnosis in peri pheral neuropathy. While direct compression and infiltration of spinal roots or peripheral or cranial nerve trunks or branches can be identi fied easily when they occur in association with established malignancy , their diagnosis when they are presenting features may be difficult. In paraneoplastic sensory neuronopathy autoantibodies to neuronal anti gens have become useful diagnostic markers for an underlying carcinoma , especially anti-Hu antibodies. Strong circumstantial evidence sugges ts that these antibodies form part of an autoimmune response which is responsible for the pathogenesis of some of these syndromes. Neuropath y appearing during the course of treatment of carcinoma may be due to radiation-induced damage or the neurotoxic effects of some chemotherap eutic agents, Neurotrophic factors are being investigated as a strateg y for reducing the neurotoxic effects of these agents.