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Paraneoplastic Encephalomyelitis Treatment & Management

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

Medical Care

Timely diagnosis of paraneoplastic encephalomyelitis (PEM) is critical to allow for appropriate treatment of the underlying malignancy.[17]

  • Immunosuppressive therapies are used frequently to treat PEM; however, no benefit has been documented.[18]
  • Plasmapheresis may be instituted alone or in combination with other immunosuppressive therapies.
  • As remission of neurologic sequelae occasionally has followed complete treatment of the tumor[19] , efforts should be directed to the diagnosis and treatment of the associated cancer.
  • Treatment of PEM includes physical therapy, symptomatic care, and prevention of medical complications.
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Surgical Care

Surgical treatment options do not exist other than for the primary cancer.

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Consultations

See the list below:

  • Neurologist
  • Oncologist
  • Rehabilitation specialist
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Diet

Specific dietary requirements do not exist, although aspiration precautions may be necessary in debilitated patients.

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Activity

The presence of neurologic deficits and postural hypotension may necessitate supervision of activity or precautions to avoid falls.

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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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