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{{CMG}} {{AE}} {{MV}} | {{CMG}} {{AE}} {{MV}} | ||
{{SK}} | {{SK}} Cerebellar ataxia due to neoplasia; | ||
==Overview== | ==Overview== | ||
'''Paraneoplastic cerebellar degeneration''' (PCD) is a [[paraneoplastic syndrome]] associated with [[lung]], [[ovarian]], [[breast]], [[Hodgkin’s lymphoma]]<ref name=terrance>{{cite journal|last=O'Brien|first=Terrence J.|author2=Pasaliaris, Bill |author3=D'Apince, Anthony |author4= Byrne, Edward |title=Anti-Yo positive paraneoplastic cerebellar degeneration: a report of three cases and review of the literature|journal=Journal of Clinical Neuroscience|year=1995|volume=2|issue=4|pages=316–320|doi=10.1016/0967-5868(95)90052-7}}</ref> and other [[cancer]]s. PCD is a rare condition that occurs in less than 1% of cancer patients<ref name=terrance /><ref name=Abdul>{{cite journal|last=Rana|first=Abdul, Oayyu|author2=Ranna, A.N. |author3=Adul, Ashfique |title=Acute ataxia due to anti-Yo antibody paraneoplastic cerebellar degeneration 4 months prior to diagnosis of uterine carcinoma|journal=Acta Neurologica Belgica|year=2012}}</ref><ref name=Finsterer>{{cite journal|last=Finsterer|first=Josef|author2=Voigtlander, Till |author3=Grisold, Wolfgang |title=Deterioration of anti-Yo-associated paraneoplastic cerebellar degeneration|journal=Journal of the Neurological Sciences|year=2011|volume=308|pages=139–141|doi=10.1016/j.jns.2011.06.051}}</ref> and usually occurs in middle-aged women. | |||
==Historical Perspective== | ==Historical Perspective== | ||
*Paraneoplastic cerebellar degeneration was first | *Paraneoplastic cerebellar degeneration was first described in early 1980. | ||
==Classification== | ==Classification== | ||
Paraneoplastic cerebellar degeneration according to the presence or absence of an antibody, into several categories. | |||
==Pathophysiology== | ==Pathophysiology== | ||
*The pathogenesis of | *The pathogenesis of paraneoplastic cerebellar degeneration is characterized by the presence of anti-Purkinje cell antibodies | ||
*The | *The antibodies that have been associated with the development of paraneoplastic cerebellar degeneration, include: | ||
*On gross pathology, | :*Anti-P/Q type calcium channel antibodies | ||
*On microscopic histopathological analysis, | :*Anti-Tr antibodies | ||
:*Anti-Ri (ANNA-2) | |||
:*Anti-CV2 | |||
:*Antibodies to Ma proteins | |||
:*Antibodies to the Zic4 | |||
*On gross pathology, characteristic findings of paraneoplastic cerebellar degeneration, include: | |||
:* | |||
:* | |||
:* | |||
*On microscopic histopathological analysis,findings of paraneoplastic cerebellar degeneration, include: | |||
:* | |||
:* | |||
:* | |||
==Causes== | ==Causes== | ||
* | * Causes of paraneoplastic cerebellar degeneration, include: | ||
==Differentiating Paraneoplastic Cerebellar Degeneration from other Diseases== | |||
==Differentiating | *Paraneoplastic cerebellar degeneration must be differentiated from other diseases that cause ataxia, dizziness, and nausea such as: | ||
*Paraneoplastic cerebellar degeneration must be differentiated from other diseases that cause | |||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
* The prevalence of | * The prevalence of paraneoplastic cerebellar degeneration is approximately [number or range] per 100,000 individuals worldwide. | ||
===Age=== | ===Age=== | ||
*Patients of all age groups may develop [disease name]. | *Patients of all age groups may develop [disease name]. | ||
Revision as of 15:33, 13 April 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Synonyms and keywords: Cerebellar ataxia due to neoplasia;
Overview
Paraneoplastic cerebellar degeneration (PCD) is a paraneoplastic syndrome associated with lung, ovarian, breast, Hodgkin’s lymphoma[1] and other cancers. PCD is a rare condition that occurs in less than 1% of cancer patients[1][2][3] and usually occurs in middle-aged women.
Historical Perspective
- Paraneoplastic cerebellar degeneration was first described in early 1980.
Classification
Paraneoplastic cerebellar degeneration according to the presence or absence of an antibody, into several categories.
Pathophysiology
- The pathogenesis of paraneoplastic cerebellar degeneration is characterized by the presence of anti-Purkinje cell antibodies
- The antibodies that have been associated with the development of paraneoplastic cerebellar degeneration, include:
- Anti-P/Q type calcium channel antibodies
- Anti-Tr antibodies
- Anti-Ri (ANNA-2)
- Anti-CV2
- Antibodies to Ma proteins
- Antibodies to the Zic4
- On gross pathology, characteristic findings of paraneoplastic cerebellar degeneration, include:
- On microscopic histopathological analysis,findings of paraneoplastic cerebellar degeneration, include:
Causes
- Causes of paraneoplastic cerebellar degeneration, include:
Differentiating Paraneoplastic Cerebellar Degeneration from other Diseases
- Paraneoplastic cerebellar degeneration must be differentiated from other diseases that cause ataxia, dizziness, and nausea such as:
Epidemiology and Demographics
- The prevalence of paraneoplastic cerebellar degeneration is approximately [number or range] per 100,000 individuals worldwide.
Age
- Patients of all age groups may develop [disease name].
- Paraneoplastic cerebellar degeneration is more commonly observed among patients aged [age range] years old.
- Paraneoplastic cerebellar degeneration is more commonly observed among [elderly patients/young patients/children].
Gender
- Paraneoplastic cerebellar degeneration affects men and women equally.
- [Gender 1] are more commonly affected with [disease name] than [gender 2].
- The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
Race
- There is no racial predilection for [disease name].
- Paraneoplastic cerebellar degeneration usually affects individuals of the [race 1] race.
- [Race 2] individuals are less likely to develop [disease name].
Risk Factors
- Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
Natural History, Complications and Prognosis
- The majority of patients with [disease name] remain asymptomatic for [duration/years].
- Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
- If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
- Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
- Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with [disease name] is approximately [#%].
Diagnosis
Diagnostic Criteria
- The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
- [criterion 1]
- [criterion 2]
- [criterion 3]
- [criterion 4]
Symptoms
- Paraneoplastic cerebellar degeneration is usually asymptomatic.
- Symptoms of [disease name] may include the following:
- [symptom 1]
- [symptom 2]
- [symptom 3]
- [symptom 4]
- [symptom 5]
- [symptom 6]
Physical Examination
- Patients with [disease name] usually appear [general appearance].
- Physical examination may be remarkable for:
- [finding 1]
- [finding 2]
- [finding 3]
- [finding 4]
- [finding 5]
- [finding 6]
Laboratory Findings
- There are no specific laboratory findings associated with [disease name].
- A [positive/negative] [test name] is diagnostic of [disease name].
- An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
- Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
Imaging Findings
- There are no [imaging study] findings associated with [disease name].
- [Imaging study 1] is the imaging modality of choice for [disease name].
- On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
- [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
- Paraneoplastic cerebellar degeneration may also be diagnosed using [diagnostic study name].
- Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
- There is no treatment for [disease name]; the mainstay of therapy is supportive care.
- The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
- [Medical therapy 1] acts by [mechanism of action1].
- Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
Surgery
- Surgery is the mainstay of therapy for [disease name].
- [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
- [Surgical procedure] can only be performed for patients with [disease stage] [disease name].
Prevention
- There are no primary preventive measures available for [disease name].
- Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
- Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
References
- ↑ 1.0 1.1 O'Brien, Terrence J.; Pasaliaris, Bill; D'Apince, Anthony; Byrne, Edward (1995). "Anti-Yo positive paraneoplastic cerebellar degeneration: a report of three cases and review of the literature". Journal of Clinical Neuroscience. 2 (4): 316–320. doi:10.1016/0967-5868(95)90052-7.
- ↑ Rana, Abdul, Oayyu; Ranna, A.N.; Adul, Ashfique (2012). "Acute ataxia due to anti-Yo antibody paraneoplastic cerebellar degeneration 4 months prior to diagnosis of uterine carcinoma". Acta Neurologica Belgica.
- ↑ Finsterer, Josef; Voigtlander, Till; Grisold, Wolfgang (2011). "Deterioration of anti-Yo-associated paraneoplastic cerebellar degeneration". Journal of the Neurological Sciences. 308: 139–141. doi:10.1016/j.jns.2011.06.051.