It also occurs in adults with various cancers. In children, the neurologic symptoms respond to treatment with corticosteroids and to antitumor therapy. Paraneoplastic Sensory Neuropathy Paraneoplastic sensory neuropathy is marked by loss of sensation, with relative preservation of motor power. CSF pleocytosis is common at onset but resolves in a few weeks. Pathologic findings include destruction of the dorsal root ganglia and the posterior columns of the spinal cord, perivascular lymphocytic cuffing, and wallerian degeneration of sensory nerves.
Many patients also have inflammatory and degenerative changes in the brain and spinal cord.
Lambert-Eaton Myasthenic Syndrome LEMS is characterized by proximal muscle weakness with ptosis, dry mouth, and impotence. Physical examination reveals that the patient has greater strength than would be expected from his or her complaint and that when the patient makes a sustained effort, strength increases over several seconds. Deep tendon reflexes at the knees and ankles are usually absent but sometimes return transiently with exercise. Diagnosis is made with electrical studies. Successful treatments include plasma exchange and eradication of the underlying cancer.