Distinguishing Paraneoplastic Neurologic Syndromes From Immune-Related Neurologic Toxicities

WATCH TIME: 5 minutes | Captions are auto-generated and may contain errors.

This clinical video series, titled “Crossroads in Neuro-Oncology: Understanding Paraneoplastic Neurologic Syndromes,” is a NeurologyLive^® Roundtable Discussion focused on the recognition and management of paraneoplastic neurologic syndromes (PNS) in patients with cancer. These immune mediated neurologic disorders can present across the cancer continuum and may cause rapid functional decline, underscoring the importance of early identification, appropriate diagnostic evaluation, and coordinated multidisciplinary care.

In collaboration with Northwestern Medicine, neuro-oncology experts Shailee Samir Shah, MD, clinical assistant professor of neurology, and Ditte Primdahl, MD, assistant professor of neurology, joined host Jax DiEugenio to provide a clinical overview of PNS. The discussion covered real-world presentation patterns, diagnostic considerations, screening protocols, and patient selection criteria. The experts also evaluate modern therapeutic interventions and practical management strategies while exploring the evolving treatment landscape for PNS.

In this third episode, Shah and Primdahl discussed how neuro-oncologists differentiate classic PNS from immune-related neurologic adverse effects associated with immune checkpoint inhibitors. They highlighted clinical features that may suggest an immune-mediated toxicity is unmasking or exacerbating an underlying paraneoplastic syndrome. The pair then explained how prior exposure to immunotherapy can influence diagnostic confidence and treatment selection in patients with suspected PNS. The duo of experts also addressed the challenge of balancing neurologic stabilization with continuation of potentially life-prolonging immunotherapy.

Click here to watch more episodes of this video series.