J Neurooncol (2017) 134:243–244 DOI 10.1007/s11060-017-2501-1 LETTER TO THE EDITOR Paraneoplastic neuromyotonia due to lung carcinoma and invisible muscle cramps evaluated using ultrasonography 1 1 1 Kenya Nishioka · Kazuaki Kanai · Nobutaka Hattori Received: 21 March 2017 / Accepted: 20 May 2017 / Published online: 26 May 2017 © Springer Science+Business Media New York 2017 To the Editor, lateralis, tibialis anterior, and gastrocnemius muscles, simi- lar to a previous report . It revealed persistent and invol- Paraneoplastic neuromyotonia (PN) is rarely observed in untary contractions in the hypodermal muscles of the trape- patients with malignant tumors, presenting as spontane- zius (left), deltoid (right and left), tibialis anterior (right), ous and continuous muscle overactivity . Most of the and gastrocnemius (right) (Video 1). Regarding malignancy patients report cramps, muscle twitching, myokymia, and survey, the levels of carcinoembryonic antigen, soluble stiffness. Here, we report the case of a patient with persis- cytokeratin 19 fragment, and progastrin-releasing peptide tent and invisible muscle twitching, evaluated using needle in the peripheral blood were elevated to 8.0 ng/mL (normal electromyography (EMG) and ultrasonography. After hav- <5.0), 6.2 ng/mL (normal <3.5), and 159 pg/mL (normal ing diagnosed neuromyotonia, we detected lung cancer, <80.9), respectively. Chest computed tomography (CT) large cell
Journal of Neuro-Oncology – Springer Journals
Published: May 26, 2017
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