Paraneoplastic lower motor neuronopathy associated with Hodgkin lymphoma.
BACKGROUND
Paraneoplastic lower motor neuronopathies have been reported rarely with Hodgkin lymphoma.


METHODS
We report a case of rapidly progressive motor neuronopathy preceding the diagnosis of Hodgkin lymphoma.


RESULTS
A 31-year-old woman developed subacute rapidly progressive quadriparesis. Electrodiagnostic studies revealed a severe diffuse disorder of motor neurons and their axons. Symmetric enhancement of the cauda equina motor nerve roots was notable on magnetic resonance imaging scan. Further imaging demonstrated an enlarged supraclavicular lymph node, and biopsy revealed Hodgkin lymphoma. A final diagnosis of paraneoplastic motor neuronopathy was made after investigations for alternative causes of motor neuronopathy were unrevealing. Neurological improvement was seen with combined treatment of the underlying malignancy and intravenous immunoglobulin.


CONCLUSIONS
Paraneoplastic causes should be considered in the differential diagnosis of subacute motor neuronopathy, as the neurological presentation may precede cancer detection. Combinations of lymphoma treatment and immunotherapy may result in a favorable outcome.
Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA.
Eoin P
EP
Flanagan
Paola
P
Sandroni
Sean J
SJ
Pittock
David J
DJ
Inwards
Lyell K
LK
Jones
D000328:Adult; D002420:Cauda Equina / Q000473:pathology / Q000502:physiology; D005260:Female; D006689:Hodgkin Disease / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D009046:Motor Neurons / Q000473:pathology* / Q000502:physiology; D009431:Neural Conduction / Q000502:physiology; D020364:Paraneoplastic Polyneuropathy / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D010524:Peripheral Nervous System Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology