Paraneoplastic Encephalomyelitis Treatment & Management

Updated: Sep 09, 2016
  • Author: David S Liebeskind, MD, FAAN, FAHA, FANA; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Treatment

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

Consultation with the following may prove useful:

  • 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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