title: Paraneoplastic myelopathy.
abstract: Paraneoplastic causes are a rare but important diagnostic consideration when evaluating myelopathy because neurologic symptoms may herald a diagnosis of cancer. Spinal cord MRI findings of longitudinally extensive, symmetric, tract-specific T2-signal changes occasionally with gadolinium enhancement are characteristic. Detection of neural-specific autoantibodies assists in confirming the diagnosis and guides the cancer search. Initial management involves detection and treatment of the underlying cancer. Combinations of immunotherapies are typically recommended but evidence-based therapeutic guidelines are lacking and morbidity remains high. Autoimmune myelopathies may also occur in association with neural-specific autoantibodies without an underlying cancer and in association with systemic autoimmune disorders.
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA. flanagan.eoin@mayo.edu
authors.forename: Eoin P
authors.initials: EP
authors.lastname: Flanagan
authors.forename: B Mark
authors.initials: BM
authors.lastname: Keegan
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging; D010257:Paraneoplastic Syndromes / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D013116:Spinal Cord / Q000473:pathology*; D013118:Spinal Cord Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy