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Paraneoplastic Sensory Neuropathy — RACP Adult Medicine MCQ

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HardNeurologyParaneoplastic Sensory NeuropathyRACP Adult Medicine

A 65-year-old woman with breast cancer presents with progressive painful sensory loss and ataxia. She has absent deep tendon reflexes and impaired proprioception. Nerve conduction studies show a pure sensory neuronopathy (non-length-dependent). Anti-Hu (ANNA-1) antibodies are positive. What is the most likely paraneoplastic syndrome?

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Correct answer: A — Sensory neuropathy

Non-length-dependent sensory neuronopathy (ganglionopathy) with anti-Hu antibodies in the context of SCLC (or breast cancer) is paraneoplastic sensory neuropathy. Unlike typical polyneuropathy, it affects cell bodies in the dorsal root ganglia producing asymmetric, non-length-dependent sensory loss. Painful dysaesthesias and sensory ataxia are characteristic.

Reference: PNS-Care 2024; eTG Neurology 2024