title: [Classic paraneoplastic syndromes: diagnostic and treatment approach].
abstract: BACKGROUND
  Paraneoplastic neurological syndromes are important complications of cancer that are usually immune mediated. According to the clinical and immunological features, two groups of disorders can be considered. One group includes disorders mediated by antibodies against cell surface neuronal antigens; these syndromes often respond to treatment and have a favorable outcome. The other group includes disorders associated with antibodies against intracellular antigens; these syndromes are likely mediated by T-cell mechanisms, respond poorly to treatment, and have a less favorable outcome.
  
  
  METHODS
  Clinical and immunological analysis, and follow-up of four patients with classical paraneoplastic syndromes.
  
  
  RESULTS
  Three patients had serum and CSF antibodies to intracellular antigens and one had no detectable antibodies. Despite the severity of the symptoms, prompt detection and treatment of the tumor and immunotherapy modified the course of the disease and resulted in substantial improvement of the quality of life.
  
  
  CONCLUSIONS
  Prompt diagnosis of the tumor and immunotherapy may positively impact the clinical outcome and improve the quality of life of patients with paraneoplastic syndromes believed to have a poor prognosis.
authors: Hospital de la Universidad de Pensilvania, Filadelfia, Estados Unidos.
authors: J
authors: J
authors: Gállego Pérez-Larraya
authors: J
authors: J
authors: Dalmau
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007167:Immunotherapy; D008297:Male; D009369:Neoplasms / Q000150:complications; D020361:Paraneoplastic Syndromes, Nervous System / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology / Q000628:therapy*