Recognizing and Managing Paraneoplastic Neurological Syndromes: Ditte Primdahl, MD; Shailee Samir Shah, MD

WATCH TIME: 3 minutes

"It's actually not infrequent that we see patients and diagnose them with a syndrome, and then later on find out that they have an underlying cancer that was not diagnosed."

Neuro-oncology is a subspecialty focused on the study and treatment of tumors impacting the central and peripheral nervous systems. With collaboration across multiple disciplines, it includes the management of both primary brain and spinal cord tumors as well as metastatic cancers involving the nervous system. The field also encompasses the assessment of neurological complications related to cancer and its therapies. Ongoing research aims to inform clinical approaches through advancements in diagnostics, treatment modalities, and understanding of tumor biology.¹

At the recently concluded 2025 American Academy of Neurology (AAN) Annual Meeting, held April 5-9, in San Diego, California, a program focused on recent developments in the management of central nervous system tumors.² In the session, presentations covered clinical trial data and discussed how emerging evidence may inform treatment approaches. Ugur Sener, MD, one of the presenters, provided an overview of updates related to IDH-mutated astrocytoma, while Lauren Schaff, MD, FAAN, discussed current evidence in the management of glioblastoma. The session concluded with a Neuro-oncology Tumor Board led by Wendy Sherman, MD, Sener, and Schaff, where participants examined case-based applications of evolving practices in neuro-oncology.

Following the session, Feinberg School of Medicine experts Ditte Primdahl, MD, assistant professor of neurology, and Shailee Samir Shah, MD, clinical assistant professor of neurology, sat down with NeurologyLive^® to discuss the session topics. In the conversation, the duo emphasized the importance of maintaining a high index of suspicion for paraneoplastic neurological syndromes, a group of rare conditions that develop in some patients who have cancer. They outlined clinical phenotypes suggestive of these syndromes and highlighted the growing role of immune checkpoint inhibitors in triggering autoimmune complications. Above all, Primdahl and Shah also discussed advancements in identifying autoantibodies through proteomic techniques and the ongoing efforts to better understand intracellular mechanisms that may influence treatment response.

Click here for more coverage of AAN 2025.

REFERENCES
1. Barbaro M, Fine HA, Magge RS. Foundations of Neuro-Oncology: A Multidisciplinary Approach. World Neurosurg. 2021;151:392-401. doi:10.1016/j.wneu.2021.02.059
2. Sener U, Schaff L, Sherman W. Neuro-oncology: Navigating Current Trends. Presented at: 2025 AAN Annual Meeting; April 5-9; San Diego, CA.