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Sensory ataxia and pain are the most common manifestations of paraneoplastic neuropathy. Neurologic manifestations often occur before the cancer — most commonly, a small-cell lung cancer — is detected. To better characterize these syndromes, investigators reviewed findings from clinical exams and sural nerve biopsies in 17 patients with paraneoplastic neuropathy. Four patients had predominantly painful neuropathy; the other 13 patients had severe ataxia, 8 of whom had milder pain.
Onset of neuropathy was asymmetric in most patients. Both types of neuropathy had some motor involvement. Anti-Hu antibodies, a classic marker of ataxic paraneoplastic neuropathy, were found in only 7 patients with ataxia (and in 2 with the painful form). Morphomet…