Pain as a First Manifestation of Paraneoplastic Neuropathies: A Systematic Review and Meta-Analysis

Panagiotis Zis, Antonella Paladini, Alba Piroli, Patrick C McHugh, Giustino Varrassi, Marios Hadjivassiliou

Research output: Contribution to journalReview articlepeer-review

33 Citations (Scopus)


INTRODUCTION: Paraneoplastic neurological syndromes (PNS) consist of a heterogeneous group of neurological disorders triggered by cancer. The aim of this systematic review is to estimate the reported prevalence of pain in patients with paraneoplastic peripheral neuropathy (PPN).

METHODS: A systematic computer-based literature search was conducted on PubMed database.

RESULTS: Our search strategy resulted in the identification of 126 articles. After the eligibility assessment, 45 papers met the inclusion criteria. Full clinical and neurophysiological data were further extracted and involved 92 patients with PPN (54.5% males, mean age 60.0 ± 12.2 years). The commonest first manifestation of PPN is sensory loss (67.4%), followed by pain (41.3%), weakness (22.8%), and sensory ataxia (20.7%). In 13.0% of the cases, pain was the sole first manifestation of the PPN. During the course of the PPN, 57.6% of the patients may experience pain secondary to the neuropathy.

CONCLUSIONS: Pain is very prevalent within PPN. Pain specialists should be aware of this. Detailed history-taking, full clinical examination, and requesting nerve conduction studies might lead to an earlier diagnosis of an underlying malignancy.

Original languageEnglish
Pages (from-to)143-151
Number of pages9
JournalPain and Therapy
Issue number2
Early online date1 Jul 2017
Publication statusPublished - 1 Dec 2017


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