| Specific Conditions |
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| Level of Evidence | Insufficient data (Category 4a) |
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Ig therapy is not supported for paraneoplastic subacute sensory neuropathy, associated with onconeural antibodies directed against intracellular antigens (Hu, Ri, CV2/CRMP5). Response to immune therapy is poor in these paraneoplastic disorders, likely due to cytotoxic T-cell mediated neuronal loss. Therefore, onconeural autoantibodies are considered biomarkers for the presence of tumours rather than pathogenic mediators of neurologic disease, and should motivate the search for an associated malignancy. Tumour resection and/or oncological treatment are the most effective therapies for these paraneoplastic neurologic syndromes, with case series reporting variable roles for corticosteroids, cyclophosphamide and rituximab. |
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