title: Is peripheral paraneoplastic neurological syndrome possible in primary brain tumors?
abstract: Systemic malignant diseases cause the induction of autoimmunity, for example, paraneoplastic syndromes. There are no proofs of paraneoplastic syndromes in primary brain tumors. The aim of the study was to evaluate the involvement of the peripheral nervous system, together with an assessment of onconeuronal and antineural antibodies as indicators of humoral immune response against nervous system in patients with primary brain tumors.
  
  
  
  Clinical examinations, electrophysiological studies of peripheral nerves (motor and sensory conduction velocity studies, conduction velocity distribution tests, thermal and vibratory quantitative sensory tests, and sympathetic skin response tests) and muscles, blood sampling collection (assessment of onconeuronal, and antineural antibodies) were performed on 33 patients with newly recognized primary brain tumors within 2-4 days after their admission to our department.
  
  
  
  We revealed statistically significant changes of peripheral nerves, more pronounced in the peroneal nerve in standard and conduction velocity distribution tests, as well as in sympathetic skin responses. We revealed significantly higher vibratory thresholds, and pain thresholds for cold and warm in the upper and lower limbs in the study group than in the controls. In five patients, we have identified anti-neuroendothelium, anti-GFAP, anti-MAG, anti-PCNA, and anti-Ro52 antibodies.
  
  
  
  In patients with primary brain tumors, electrophysiological changes in peripheral nerves, together with the presence of the antineural antibodies suggest an autoimmune humoral response, and make the diagnosis of paraneoplastic neurological syndrome possible.
authors.affiliation: Department of Neurology Wroclaw Medical University Borowska 213 51-669 Wroclaw Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Koszewicz
authors.affiliation: Department of Neurochemistry and Neuropathology Poznan University of Medical Sciences Poznan Poland; Neuroimmunological Unit Miroslaw Mossakowski Medical Research Center of the Polish Academy of Sciences Wroclaw Poland.
authors.forename: Slawomir
authors.initials: S
authors.lastname: Michalak
authors.affiliation: Department of Neurology Wroclaw Medical University Borowska 213 51-669 Wroclaw Poland.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Bilinska
authors.affiliation: Department of Neurology Wroclaw Medical University Borowska 213 51-669 Wroclaw Poland.
authors.forename: Slawomir
authors.initials: S
authors.lastname: Budrewicz
authors.affiliation: Division of Gynecologic Oncology Department of Gynecology, Obstetrics and Gynecologic Oncology Poznan University of Medical Sciences Poznan Poland.
authors.forename: Mikolaj
authors.initials: M
authors.lastname: Zaborowski
authors.affiliation: Department of Neurology Wroclaw Medical University Borowska 213 51-669 Wroclaw Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Slotwinski
authors.affiliation: Department of Neurology Wroclaw Medical University Borowska 213 51-669 Wroclaw Poland.
authors.forename: Ryszard
authors.initials: R
authors.lastname: Podemski
authors.affiliation: Department of Neurology Wroclaw Medical University Borowska 213 51-669 Wroclaw Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Ejma
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000276:immunology*; D009431:Neural Conduction / Q000502:physiology; D020361:Paraneoplastic Syndromes, Nervous System / Q000209:etiology / Q000276:immunology / Q000503:physiopathology; D010525:Peripheral Nerves / Q000503:physiopathology*; D010543:Peroneal Nerve / Q000503:physiopathology; D012684:Sensory Thresholds / Q000502:physiology; D012867:Skin / Q000294:innervation*; D013564:Sympathetic Nervous System / Q000503:physiopathology*
chemical_list: D009419:Nerve Tissue Proteins
keywords: Antineural antibodies; neurography; onconeural antibodies; paraneoplastic syndrome; peripheral neuropathy; primary brain tumor