Recommended diagnostic criteria for paraneoplastic neurological syndromes
Recommended diagnostic criteria for paraneoplastic neurological syndromes
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DOI：
10.1136/jnnp.2003.034447
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发表时间：
2004-08-01
影响因子：
11
通讯作者：
Voltz, R
中科院分区：
文献类型：
--
作者：
Graus, F;Delattre, JY;Voltz, R
背景：副肿瘤神经综合征（PNS）的定义是存在癌症并排除其他已知原因的神经症状，但这一标准并没有将“真正的”PNS与与癌症同时发生的神经综合征区分开来。目的：为PNS提供更严格的诊断标准。方法：一个对PNS感兴趣的国际神经学家小组确定了那些在以前的研究中被定义为“经典”的人。该小组审查了现有的诊断标准，并为那些过去没有达成临床共识的患者推荐了新的诊断标准。该小组审查了所有报告的神经抗体，并建立了识别那些将被标记为“特征良好”的抗体的条件。抗体信息是从参与这项研究的不同实验室发表的论文和未发表的数据中获得的。结果：专家组建议将神经系统综合征定义为副肿瘤的证据分为两个级别：“确定”和“可能”。每个级别都可以结合一套基于癌症存在与否的标准以及“经典”综合征和“特征明确”的肿瘤神经抗体的定义来达到。结论：提出的标准有助于临床医生对患者进行分类，并对PNS病例进行前瞻性和回顾性分析。
Background: Paraneoplastic neurological syndromes (PNS) are defined by the presence of cancer and exclusion of other known causes of the neurological symptoms, but this criterion does not separate "true'' PNS from neurological syndromes that are coincidental with a cancer.Objective: To provide more rigorous diagnostic criteria for PNS.Methods: An international panel of neurologists interested in PNS identified those defined as "classical'' in previous studies. The panel reviewed the existing diagnostic criteria and recommended new criteria for those in whom no clinical consensus was reached in the past. The panel reviewed all reported onconeural antibodies and established the conditions to identify those that would be labelled as "well characterised''. The antibody information was obtained from published work and from unpublished data from the different laboratories involved in the study.Results: The panel suggest two levels of evidence to define a neurological syndrome as paraneoplastic: "definite'' and "possible''. Each level can be reached combining a set of criteria based on the presence or absence of cancer and the definitions of "classical'' syndrome and "well characterised'' onconeural antibody.Conclusions: The proposed criteria should help clinicians in the classification of their patients and the prospective and retrospective analysis of PNS cases.