Paraneoplasm Testing
 

Did any of y'all get a paraneoplasm blood test as a part of your PN work up? Wondering if this is standard or only if a malignancy is suspected.


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I don't think it is standard. You can ask for it, if you are worried.
I wouldn't ask just yet... wait and see what develops.

Lung cancer, ovarian cancer, and some bone marrow cancers can cause paraneoplastic PN. But it is not really that common either.
It tends to be a more dramatic presentation with severe symptoms.

Thanks

Are you talking about the neurological symptoms being more severe or the actual malignancy?

The PN symptoms are fairly severe...fast onset, etc.

http://en.wikipedia.org/wiki/Paraneoplastic_syndrome

Thanks MrsD...in your opinion based off what I shared on here do I fall outside the severe category?

You are still running, working and have times with little pain?

That would not be possible with a paraneoplastic neuropathy.

more here:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1736440/

Boom!! Thank you for your help.

I was given a paraneoplastic panel.
Apparently, a neuropathy can start before the cancer symptoms start, so if something is found in that panel, you may be tested for various types of cancer.
I went through numerous tests to rule out cancer because a VGKC anti body was found. I did not end up having any type of cancer.

[QUOTE=UTGrad;1134449]Did any of y'all get a paraneoplasm blood test as a part of your PN work up? Wondering if this is standard or only if a malignancy is suspected.


I did get paraneoplasm blood testing done, but that was when my primary symptoms were muscle twitching/cramping that had no other apparent neurological cause. I don't think it is a standard test for general PN symptoms.

i think you mean paraneoplastic test. paraneoplastic syndrome is distinct for the type of cancer causing it, some can overproduce hormones or neuropeptides like serotonin. paraneoplastic syndrome causes other symptoms other than neuropathy, and they are severe, and has to be assessed by a oncologist, endocrinologist, and technically is not a PN cause, PN is probably secondary to the cancer, if it is suspected. Paraneoplastics are pretty uncommon unless its in an endocrine tumor, that secretes substances., but the OP runs everyday, which can cause neuropathy, running show be done a few times a week. All that constant pounding on your legs, and spine when running is not good.

My initial primary symptoms before the weakness were twitching and cramping too.....are these your current symptoms? If so, maybe it's these symptoms with no other cause that lead to the paraneoplastic panel being done?
I just assumed it was a regular part of the neuropathy work up when my doctor ordered it.

I was having some twitching but to be honest I've had benign fasciculations for years.

I had it off and on randomly, before it went haywire in januarary, where i was having the twitching frequently in one setting, it appeared the same time my other neuropathies appeared, in januarary.

The single most useful thing for twitching is magnesium.
You can try SlowMag twice a day or topical mag like
Morton's epsom lotion. Magnesium calms muscle tension
And improves circulation to muscles.

Note that BFS and CFS fasciculation syndromes often produce tingling and numbness. So does Fibromyalgia and chronic fatigue syndrome. In general the presence of fasciculations and neuropathy due to the same underlying cause is rare according to my neurologist.

I thought I read somewhere the folks with BFS often have small fiber PN.

Oh well chalk it up to another odd variant in my physiological makeup.

I have watched the net over the past years, develop the term
BFS. It is not a diagnosis but only a descriptive term used for the symptoms.

During this time the studies on magnesium intake in the diet have paralleled the BFS term... up to 70% and maybe more do not get the RDA of magnesium from the diet. Or they lose it quickly thru lifestyle choices. Caffeine and alcohol increase magnesium excretion, and so does glucose intolerance and diabetes.

In fact heavy daily exercise may deplete it more, since magnesium is used by mitochondria to make the membranes of those energy factories more efficient. It is also used by muscles along with pyridoxal, to metabolize carbohydrates.

from http://www.ncbi.nlm.nih.gov/pubmed/17172008

A good resource to help athletes consume more magnesium from foods is:
http://www.slowmag.com/
This dosage form was developed with doctors in mind, when the oxide form that was historically used before was discovered to be useless as a supplement. However, this dosage form remains over the counter, and does not require a prescription. The average dose is one tablet twice a day.

In fact more and more discussion is available now on the net along with studies to show that heavy running habits, are not as healthy as people used to believe:
http://www.latimes.com/science/scien...202-story.html

This might be due in part to the heavy requirements the body has for magnesium, and since most people don't even get the RDA, the extra load needed for heavy exercise creates the potential for damage.

We have seen in an extended family member, who was a pilot in the Air Force, and is now retired and a commercial pilot.. who did his running as part of his fitness routine... he has had to have both hips replaced recently (and he is only in his 50's.)
The wear and tear he has experienced has this price for him.

There are many more articles like this on the net:
http://www.bbc.com/news/health-31095384

So moderation is the key, and also paying attention to the nutrients you need to exercise safely.

I was tested for this. Came back with positive antibodies to acetylcholine ganglionic receptors. Did a PET scan that was negative for cancer. I don't think pareoneoplastic testing is done in an initial neuropathy workup, but they think about it when other causes are crossed off the list.

Interestingly, I have had benign muscle twitching for about 6 yrs, along with both SFN and length-dependent neuropathy for the last 13 yrs. Taking magnesium does take the frequency down a few notches.

The twitching and cramping were my initial symptoms, followed a little later by "perceived weakness" in the legs. At one point I had convinced myself I had a motor neuron disease. When the EMG tests pretty much ruled out MND, the neurologist ordered the paraneoplastic panel as kind of a "shot in the dark", since there were no other neurological signs, and paraneoplasm (particularly certain lung cancers) can apparently cause the twitching/cramping symptoms. Over time, the weakness seemed to resolve itself and the twitching/cramping were being controlled by Gabapentin. Just when I started to think I was OK, the burning feet started, and now I'm scouring this board for answers. :(

There was a study that investigated whether BFS was essentially a symptom of SFN :

http://www.neurology.org/cgi/content...tracts/P01.139

The bottom line was that: "Many patients with BFS exhibit a significant decrease in SGNFD or ENFD, with the SGNFD preferentially affected. Small fiber neuropathy should be investigated as a potential cause or contributing factor to BFS."

That sounds like me when my neuropathy started too. Looking back, I had the twitching a long time before I had any other signs. I just thought it was due to exercising, running etc. I was checked several times for lung cancer due to the VGKC antibody.
The weakness came after the cramping/twitching and I never had any pain.

Before my neropathic pain started, I did quite a bit of research on BFS (also known as "peripheral nerve hyperexcitability syndrome"). In addition to the study I posted earlier, that investigated BFS as essentially a symptom of PN, I also noted that there is often an autoimmune issue associated with BFS - as there is with PN. The difference being that with BFS, the autoimmunity is typically associated with the potassium channels, while with PN it is associated with the Calcium and sodium channels.

I really haven't yet got my head around all the autoimmunity stuff and what it all means - just find the relationship between BFS and PN kind of interesting.