[Classic paraneoplastic syndromes: diagnostic and treatment approach].

INTRODUCTION: Paraneoplastic neurological syndromes are important complications of cancer that are usually immune mediated. According to the clinical and immunological features, two groups of disorders can be considered. One group includes disorders mediated by antibodies against cell surface neuronal antigens; these syndromes often respond to treatment and have a favorable outcome. The other group includes disorders associated with antibodies against intracellular antigens; these syndromes are likely mediated by T-cell mechanisms, respond poorly to treatment, and have a less favorable outcome.

METHODS: Clinical and immunological analysis, and follow-up of four patients with classical paraneoplastic syndromes.

RESULTS: Three patients had serum and CSF antibodies to intracellular antigens and one had no detectable antibodies. Despite the severity of the symptoms, prompt detection and treatment of the tumor and immunotherapy modified the course of the disease and resulted in substantial improvement of the quality of life.

CONCLUSIONS: Prompt diagnosis of the tumor and immunotherapy may positively impact the clinical outcome and improve the quality of life of patients with paraneoplastic syndromes believed to have a poor prognosis.