Treatment

Treatment of neurological paraneoplastic syndromes involves treating the cancer and, in some cases, suppressing the immune response that's causing your signs and symptoms. Your treatment will depend on the specific type of paraneoplastic syndrome you have, but it may include the following options.

Medications

In addition to drugs, such as chemotherapy, to combat your cancer, your doctor may prescribe one or more of the following drugs to stop your immune system from attacking your nervous system:

  • Corticosteroids, such as prednisone, inhibit inflammation. Serious long-term side effects include weakening of the bones (osteoporosis), type 2 diabetes, high blood pressure, high cholesterol and others.
  • Immunosuppressants slow the production of disease-fighting white blood cells. Side effects include an increased risk of infections. Drugs may include azathioprine (Imuran) and cyclophosphamide.

Depending on the type of neurological syndrome and symptoms, other medications may include:

  • Anti-seizure medications, which may help control seizures associated with syndromes that cause electrical instability in the brain.
  • Medications to enhance nerve to muscle transmission, which may improve symptoms of syndromes affecting muscle function. Some drugs, such as 2,3-diaminopyridine, enhance the release of a chemical messenger that transmits a signal from nerve cells to muscles. Other drugs, such as pyridostigmine (Mestinon, Regonol), prevent the breakdown of these chemical messengers.

Other medical treatments

Other treatments that may improve symptoms include:

  • Plasmapheresis. This process separates the fluid part of the blood, called plasma, from your blood cells with a device known as a cell separator. Technicians return your red and white blood cells, along with your platelets, to your body, while discarding the plasma, which contains unwanted antibodies, and replacing it with other fluids.
  • Intravenous immunoglobulin (IVIg). Immunoglobulin contains healthy antibodies from blood donors. High doses of immunoglobulin speed up the destruction of the damaging antibodies in your blood.

Other therapies

Other therapies may be helpful if a paraneoplastic syndrome has caused significant disability:

  • Physical therapy. Specific exercises may help you regain some muscle function that has been damaged.
  • Speech therapy. If you are having trouble speaking or swallowing, a speech therapist can help you relearn the necessary muscle control.
Aug. 16, 2017
References
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  4. AskMayoExpert. Paraneoplastic syndromes. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  5. Dalmau J, et al. Paraneoplastic syndromes affecting the spinal cord and dorsal root ganglia. http://www.uptodate.com/home. Accessed Nov. 28, 2016.
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