Clinical Retrospective Analysis Of The Nervous System Damages Caused By Non-nervous System Malignant Tumors

Background:There are three ways through which malignant tumors can cause nervous system damages:1. the tumors damage the nervous system directly or after metastasis.2. the tumors damage the nervous system by inducing abnormal metabolism etc.3. paraneoplastic neurological syndrome. The nervous system damages caused by the non-nervous system malignant tumors especially the paraneoplastic neurological syndromes are easily misdiagnosed clinically, thereby delaying the treatment.Objective:Retrospectively analyze the clinical characteristics of the patients, who have the syndromes of nervous system damages caused by non-nervous system malignant tumors.Method:We have reviewed the clinical data of 68 patients admitted to the neurology department in Qilu hospital Shandong University between January 1st 2005 and December 31st 2009. All the patients have syndromes of nervous system damages caused by non-nervous system malignant tumors. We retrospectively study the clinical characteristics of these patients.Result:1. Among all the 68 patients who have suffered from non-nervous system malignant tumors, there are 42 male patients,26 female patients. The ratio of male to female is 1.62:1. the range of the patients'age is form 23 to 85, there are 56 patients who are older than 50(82.4%).2. When the tumors of the patients were found, the tumors in 54 patients (79.4%) had already metastasized, including the nervous system and other system metastasis.3. Among the tumors which the patients suffer from, lung cancer is the most common tumor, there are 42 patients (61.8%) who suffer form lung cancer among all the 68 patients.4. Among all the 68 patients, there are 42 patients whose neurological syndromes are caused by the tumor infiltration or metastasis,9 patients whose neurological syndromes are caused by the tumor induced cerebral infraction and metabolic disorders,17 patients have the paraneoplastic neurological syndrome.Among the 42 patients whose neurological syndromes are caused by the tumor infiltration or metastasis,18 patients have meningeal metastasis,10 patients have brain Parenchyma metastasis,8 patients have spinal cord compression caused by metastasis,3 patients have peripheral nerve metastasis, there is each 1 patient who have cavernous sinus, occipital bone metastasis and tumor in situ infiltration.Among the 9 patients whose neurological syndromes are caused by the tumor induced cerebral infraction and metabolism disorders,5 patients have the cerebral infraction caused by tumors,4 patients have the neurological syndromes caused by tumor induced metabolic disorders.Among all the 17 patients who have the paraneoplastic neurological syndrome,3 patients have central nervous system damages(1 patient suffer from the paraneoplastic necrotic myelopathy, the rest 2 patients suffer from nonspecific encephalopathy),6 patients have paraneoplastic peripheral nerve damages (1 patient has the paraneoplastic sensory neuropathy, the rest 5 patients have the paraneoplastic motor and sensory neuropathy),5 patients have the Lambert-Eaton syndrome,1 patient suffer from both the Lambert-Eaton syndrome and central nervous system damage, there is each 1 patient who suffer from inclusion body myositis and autonomic nerve damage.5. All the 68 patients receive the blood routine examination, the hepatic function and blood biochemistry test.11 patients have hypoproteinemia,14 patients have anemia.24 patients suffer from blood biochemistry disorders, among these 24 patients, 4 patients' blood biochemistry disorders cause neurological syndromes.44 patients receive the ESR test,22 patients' results are higher than normal,51 patients receive the tumor marker test,35 patients' results are abnormal, between the pns and non-pns patients, the difference of the tumor marker abnormality positive rates has no statistical significance.6.54 patients receive the examination of MRI or CT,29 patients can find infraction or ischemia in the brain, among the 29 patients,5 patients are diagnosed as tumor induced cerebral infraction, excluding the other risk factors.Conclusion:1. Among all the 68 patients who have neurological syndrome caused by non nervous system tumors, there are more male than female. Lung cancer is the most common non-nervous system tumor which can cause neurological syndrome. When the tumors of the patients were found, most of the patients have tumor metastasis, among the metastasis to the nervous system, meningeal metastasis is common.2. The elevated ESR level has a certain tip sense to the existence of the tumor. The abnormal of the tumor markers has an important tip sense to the existence of the tumor, however the specificity is not very high.3. Non-nervous system malignant tumors may be a risk factor for cerebral infarction.4. The nervous system damages caused by the tumor infiltration, metastasis and paraneoplastic neurological syndrome are difficult to distinguish from the other nervous system disease in clinical manifestations and are easily misdiagnosed, the doctor should be vigilant. In the old patients with the similar neurological syndrome, tumor should be screened.