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Review
. 2025 Aug;43(8):1269-1285.
doi: 10.1007/s11604-025-01783-9. Epub 2025 Apr 11.

Imaging in paraneoplastic neurological syndromes: a comprehensive review

Ebinesh Arulnathan  1 , Sathyashree  2 , Praislin Gideon  3 , M Lokesh  2 , K Rajiv Gandhi  4
Affiliations
Review

Imaging in paraneoplastic neurological syndromes: a comprehensive review

Ebinesh Arulnathan et al. Jpn J Radiol. 2025 Aug.

Abstract

Paraneoplastic neurological syndromes (PNS) are a complex spectrum of clinical syndromes that are associated with underlying malignancies. Majorly being immune-mediated, these syndromes are characterized by the presence of specific paraneoplastic antibodies that are either directed against intracellular (onconeuronal) or extracellular (surface or junctional) antigens. Syndromes associated with the occurrence of onconeuronal antibodies have poor prognoses. The spectrum of neurological manifestations includes limbic encephalitis, paraneoplastic cerebellar degeneration, rhombencephalitis, myelitis, optic neuropathy, cranial neuropathies, plexopathy and polyneuropathy. This review presents a comprehensive overview of these manifestations including their imaging features, associated malignancies and antibodies, differential diagnoses and recommended further evaluation.

Keywords: Imaging features; Limbic encephalitis; Onconeuronal antibodies; Paraneoplastic antibodies; Paraneoplastic cerebellar degeneration; Paraneoplastic neurological syndromes.

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Conflict of interest statement

Declarations. Conflict of interest: The author(s) declare that they have no financial or personal relationship(s) that may have inappropriately influenced them in writing this article. Ethical approval: All procedures performed in this study involving a human participant were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Consent for publication: Informed consent was obtained from patients to publish their clinical details and use their radiological images involved in the preparation of this manuscript.

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