Paraneoplastic Neurologic Syndrome (PNS)

CNS tumors represent the second most frequent tumor of childhood and the most common pediatric solid tumor; approximately 2,200 patients under the age of 20 are diagnosed each year with invasive CNS tumors, and CNS tumors are the number one cause of death from childhood cancer. [1] Therapeutic strategies generally involve surgery as a primary intervention, but complete resection is often not possible due to tumor location. In such cases, adjunct therapies, including chemotherapy and radiation therapy, may be required based on the tumor histology and presence of residual tumor. [2]

* Weakness or numbness especially in the lower extremities, related to the myeloma cells can be nerve toxic.

Since DIPG brain tumors are on the bottom of the brain and are so close to the spinal cord most nearly all of the symptoms are caused from the tumor effecting the nervous system so bad. Symptoms include double vision, unable to close eye lids completely, dropping of one side of the face, difficulty chewing and swallowing, and difficulty balancing. Due to the tumor growing so fast and so rapidly the symptoms worsen rapidly.

Possible symptoms of a herniated disc include pain that radiates through the back and possible down the arms or legs, depending on the location of the herniation. There can also be noted numbness and weakness of the arms and neck. Some people may not even know that they have a herniated disc because not all cases present with leg or back pain. Other signs and symptoms of a herniated disc may include muscle spasms or deep muscle pain. In extreme cases, a patient may present with weakness in both legs and/or the loss of bladder control and bowel control. This is a serious problem called cauda equine syndrome and requires immediate medical attention.

Paraneoplastic syndromes are rare disorders triggered by a person's immune system in response to a cancerous tumor. Paraneoplastic syndromes can affect many areas of the body systems, including the nervous system, hormone (endocrine) system, skin (dermatologic) system, blood (hematologic) system, and joints (rheumatologic) system.

Current investigations indicate that Central neurocytoma could be of astrocytic origin or mixed lineages. Immunohistochemical tests shows multiple positive markers of neural cell that includes synaptophysin, neuron specific enolase, neuronal specific nuclear protein , and neuron specific class III beta tubulin. In addition to dense core vesicles and parallel microtubules are present in pathology. The tumor also shows positive neurofilament (NF) staining but some of the Central Neurocytoma fails to show consistent pathology. Unfortunately, the Immunohistochemical studies are not specific to draw a concrete conclusion to the origin of neurocytoma. Von Deimling et al. investigation indicated that Central neurocytoma shows glial fibrillary acidic protein (GFAP) and Syn, which is related to reactive astrocytes. Other studies were unable to attain the same results. In vitro, the tumor cells tend to become glial cells regardless of the medium of the culture. In vivo, the origin of the cells is not clear. Some researches hypothesize that CN arise from neural stem cells surrounding the ventricle zones. This hypothesize was based on high levels of choline, cholinergic receptors, gamma-aminobutyric acid, and normal or low levels of glutamate and catecholamines. Kim et al also showed the presence of Musashi-1, and the neuroep- ithelial enhancer gene nestin. These results point towards possible genetic properties to

When most hear the word addiction, they associate that with drugs, gambling and unhealthy food. Very few realize that anything, other than the bare necessities for live, can be easily turned into an addiction if one associates happiness with an object or idea. “…almost everyone who unplugs, whether for a day or a month, eventually plugs back in. We can interpret that as addiction…” (Samuel). .In the writing piece titled Attention Deficit: The Brain Syndrome of Our Era, Richard Restak analyzed the various consequences of technologies’ ubiquity in our society. Unfortunately, due to today’s reach of technology into each and every aspect of daily life, we

The main symptom of these disorders is tumors that form on the ends of nerves throughout the body. NF 1 is most commonly

Chemotherapy-induced peripheral neuropathy (CIPN) can be a severe, dose-limiting toxicity caused by the administration of the chemotherapeutics and anti-cancer biologics used to treat an individual’s cancer. The purpose of the paper is to explore the effectiveness of different treatment options for the prevention and treatment of CIPN. Additionally, this paper will determine which established assessment tools are best to evaluate CIPN in the oncology patient. Once these methods are identified, they can then be incorporated into the plan of care for at risk patients. A patient’s education related to CIPN

Borgeat et al 2001, in a prospective study of ISB using a nerve stimulator concluded that one patient with Marfan disease (0.2%) suffered pneumothorax. 0.2%of cases had episode of central nervous system toxicity in the form of incoherent speech. Aspiration of blood was encountered in 0.5%of patients but no hematoma was subsequently observed. Nerve injury after brachial plexus anesthesia varied from 0 to more than 5%. (Borgeat et al, 2001).

Cranial Nerve I (smell) is intact, pt. can identify different smells. The patient was reactive to light touch. Was able to identify a paperclip in his hand, while eyes were closed, and guessed the correct number as I traced the number 8 on the palm of his hand. The temperature was within normal range. The pain was 3 /10. Was able to guide finger to his nose but couldn’t do a heel to shin test. Did not assess reflexes due to limitations. The patient was able to follow command. Speech is clear, and he makes sense. Prescribed Gabapentin 100 mg po for neuropathy. Labs: Glucose-174, AST-35, ALT-44, ALK-53, WBC-7.7, RBC-5.32, HGB-15.6, HCT-47.0, MCV-88.5, MCH-2904, MCHC-33.2, RDW-13.7, PLT 161, and MPV-8.9.

Paraneoplastic syndromes are rare, affecting less than 0.1% of all patients with cancer(Dalmau and Rosenfeld 2008). However, the incidence of PNS varies with the neurological syndrome and with the tumor.

He also experiences occipital headaches 3 times a week, rated as 6/10. Neck pain is rated as 6-9/10. He is unable to sleep at night due to pain. Pain is worse in the morning and described as deep, dull, throbbing and stiffness. Pain is worse with cold temperature and better with rest/therapy. He also experiences numbness/tingling into his bilateral hands and fingers. Right shoulder pain is rated as 4-7/10. He is unable to sleep on that

Amid the most common neurological complications are AIDS dementia complex causing symptoms such as encephalitis (swelling of the brain), behavioral variations and a steady decline in cognitive function; central nervous system lymphomas, cancerous tumors that either start in the brain or arise from a cancer that has spread from another location in the body; cryptococcal meningitis; cytomegalovirus infections; herpes virus infections; neuropathy; neurosyphilis; progressive multifocal leukoencephalopathy (PML); and psychological and

The International Association for the study of Pain (IASP, 2012) define neuropathic pain as a complex type of pain in the nervous system caused or initiated by its primary lesion or dysfunction. Taverner (2014) has described it as “pain without purpose” because it serves no useful signalling role and does not have any beneficial effect. There is a further definition provided by the IASP neuropathic pain special group of interest: “Pain arising as a direct consequence of a lesion or disease affecting the somatosensory system” (IASP, 2010) (p.7). Many cancer disease states are related to neuropathic pain and it is often difficult to treat. Furthermore the negative impact