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Paraneoplastic Encephalomyelitis Follow-up

  • Author: David S Liebeskind, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
 
Updated: Apr 07, 2014
 

Further Outpatient Care

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  • Physical therapy
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Further Inpatient Care

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  • Physical therapy
  • Nutritional assessment
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Inpatient & Outpatient Medications

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  • Immunosuppressive medications
  • Anticonvulsants
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Transfer

Rapid diagnosis of paraneoplastic encephalomyelitis (PEM) and evaluation of an underlying malignancy should be conducted at a center with neurologic expertise and diagnostic neuroradiologic modalities available.

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Deterrence/Prevention

Preventive measures, such as smoking cessation, are focused on reducing the incidence of the associated malignancy.

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Complications

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  • Severe neurologic disability or death
  • Infections
  • Deep venous thrombosis
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Prognosis

The clinical course of PEM is unpredictable, although the titer of anti-Hu antibodies has been suggested as a prognostic indicator. Elevated titers have been associated with worse neurologic outcome and death.

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Patient Education

Public education efforts should emphasize the dangers of smoking and increase awareness of paraneoplastic disorders.

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Contributor Information and Disclosures
Author

David S Liebeskind, MD Professor of Neurology, Program Director, Vascular Neurology Residency Program, University of California, Los Angeles, David Geffen School of Medicine; Neurology Director, Stroke Imaging Program, Co-Medical Director, Cerebral Blood Flow Laboratory, Associate Neurology Director, UCLA Stroke Center

David S Liebeskind, MD is a member of the following medical societies: American Academy of Neurology, Stroke Council of the American Heart Association, American Heart Association, American Medical Association, American Society of Neuroimaging, American Society of Neuroradiology, National Stroke Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Jorge C Kattah, MD Head, Associate Program Director, Professor, Department of Neurology, University of Illinois College of Medicine at Peoria

Jorge C Kattah, MD is a member of the following medical societies: American Academy of Neurology, American Neurological Association, New York Academy of Sciences

Disclosure: Nothing to disclose.

Chief Editor

Stephen A Berman, MD, PhD, MBA Professor of Neurology, University of Central Florida College of Medicine

Stephen A Berman, MD, PhD, MBA is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, Phi Beta Kappa

Disclosure: Nothing to disclose.

Additional Contributors

Frederick M Vincent, Sr, MD Clinical Professor, Department of Neurology and Ophthalmology, Michigan State University Colleges of Human and Osteopathic Medicine

Frederick M Vincent, Sr, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, American College of Forensic Examiners Institute, American College of Legal Medicine, American College of Physicians

Disclosure: Nothing to disclose.

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Paraneoplastic encephalomyelitis.
Paraneoplastic encephalomyelitis.
Mesial temporal hyperintensity demonstrated on T2-weighted (left) and fluid-attenuated inversion recovery (FLAIR, right) MRI.
 
 
 
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