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Review
. 2017 Dec;6(2):143-151.
doi: 10.1007/s40122-017-0076-3. Epub 2017 Jul 1.

Pain as a First Manifestation of Paraneoplastic Neuropathies: A Systematic Review and Meta-Analysis

Panagiotis Zis  1   2 , Antonella Paladini  3 , Alba Piroli  3 , Patrick C McHugh  4 , Giustino Varrassi  5 , Marios Hadjivassiliou  6   7
Affiliations
Review

Pain as a First Manifestation of Paraneoplastic Neuropathies: A Systematic Review and Meta-Analysis

Panagiotis Zis et al. Pain Ther. 2017 Dec.

Abstract

Introduction: Paraneoplastic neurological syndromes (PNS) consist of a heterogeneous group of neurological disorders triggered by cancer. The aim of this systematic review is to estimate the reported prevalence of pain in patients with paraneoplastic peripheral neuropathy (PPN).

Methods: A systematic computer-based literature search was conducted on PubMed database.

Results: Our search strategy resulted in the identification of 126 articles. After the eligibility assessment, 45 papers met the inclusion criteria. Full clinical and neurophysiological data were further extracted and involved 92 patients with PPN (54.5% males, mean age 60.0 ± 12.2 years). The commonest first manifestation of PPN is sensory loss (67.4%), followed by pain (41.3%), weakness (22.8%), and sensory ataxia (20.7%). In 13.0% of the cases, pain was the sole first manifestation of the PPN. During the course of the PPN, 57.6% of the patients may experience pain secondary to the neuropathy.

Conclusions: Pain is very prevalent within PPN. Pain specialists should be aware of this. Detailed history-taking, full clinical examination, and requesting nerve conduction studies might lead to an earlier diagnosis of an underlying malignancy.

Keywords: Cancer; Pain; Paraneoplastic; Polyneuropathy.

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Figures

Fig. 1
Fig. 1
PRISMA chart
Fig. 2
Fig. 2
Pain as a symptom among the different neurophysiological types of paraneoplastic peripheral neuropathies given in percentages. SG sensory ganglionopathy, SMA sensorimotor axonal neuropathy, SN symmetrical sensory neuropathy, PM pure motor neuropathy, MMX mononeuritis multiplex
See this image and copyright information in PMC

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