Paraneoplastic disorders of the nervous system are a group of unusual disorders that develop in up to 10 to 15 percent of people who have cancer (Source: Review of Ophthalmology). These conditions occur when cancer-fighting components of your immune system also attack parts of the brain, spinal cord, nerves, or muscle.
In some cases, the optic nerve or the retina may become inflamed as part of paraneoplastic disorder (paraneoplastic optic neuropathy or retinopathy). These effects can occur without having cancer.
Problems related to vision that result from autoimmune and paraneoplastic retinopathies and optic neuropathies lead to progressive vision loss.
Tests
Comprehensive Exam - Your doctor will conduct a thorough physical examination– as well as gather a complete health history – to help determine if you have a paraneoplastic disorder. The doctor will perform tests to check your reflexes and balance, muscle strength and tone, sense of touch, and vision and hearing.
Blood Test - Your doctor may order a blood test, which can identify antibodies that are commonly associated with paraneoplastic syndromes.
Spinal Tap - Your doctor may order a spinal tap (lumbar puncture) to obtain a sample of your cerebrospinal fluid (CSF), which can identify antibodies associated with these conditions that may not show up in a blood test. To perform the lumbar puncture, a specialist inserts a tiny needle into your lower spine and removes a small amount of CSF for analysis in the laboratory.
Imaging - Your specialist may order a computerized tomography (CT) scan, magnetic resonance imaging (MRI), or positron emission tomography (PET) scan to find a tumor that may be the underlying problem or to check for other issues that could be causing your symptoms.
Optical coherence tomography - The test measures the thickness of the cell layers and nerve fibers that make up the optic nerves to assess optic nerve damage.
Optic nerve photos - The test documents the amount of optic nerve swelling.
Visual field - A visual field test assesses both central and peripheral vision.
Treatments
Corticosteroids - Your doctor may prescribe a corticosteroid medication – such as prednisone – to reduce inflammation and help manage your symptoms.
Immunosuppressants - Your doctor may prescribe an immunosuppressant medication to help slow the production of disease-fighting white blood cells and help manage your symptoms.
Other Medications - Your specialist may prescribe other types of medication – such as anti-seizure medication or medications that enhance nerve to muscle communication – depending on your specific case of paraneoplastic disorder.
Plasmaphoresis and intravenous immunoglobulin (IVIG) - Your doctor may recommend you undergo IVIg treatment to speed up the destruction of the damaging antibodies in your blood stream. Immunoglobulin contains healthy antibodies from blood donors, and so will help fight the antibodies that are causing the paraneoplastic disorder.
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Experience and expertise. A rare eye disorder demands the depth of experience and knowledge found at Bascom Palmer. Our patients have access not only to the nation’s top eye doctors, but also the most current technologies and treatments.