r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2024-29-1-4-13r-n-j-517Research ArticleОБЗОРЫREVIEWSПаранеопластические неврологические синдромы: современные подходы к диагностикеParaneoplastic neurological syndromes: upgraded approaches to diagnosishttps://orcid.org/0000-0002-6256-3429ГригорьеваВ. Н.GrigoryevaV. N.

Нижний Новгород

Nizhny Novgorod, 603950

vrgr@yandex.ruhttps://orcid.org/0000-0003-4595-2614РуинаЕ. А.RuinaE. A.

Нижний Новгород

Nizhny Novgorod, 603950

ekaterina_ruina@mail.ruФГБОУ ВО «Приволжский исследовательский медицинский университет» Минздрава РоссииРоссияFSBEI of HE “Privolzhsky Research Medical University” of the Ministry of Health of the Russian FederationRussian Federation202411032024291413Copyright © Григорьева В.Н., Руина Е.А., 20242024Григорьева В.Н., Руина Е.А.Grigoryeva V.N., Ruina E.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/517

Паранеопластические неврологические синдромы (ПарНС) представляют собой группу неврологических расстройств, в основе которых лежит аутоиммунное поражение структур нервной системы, индуцированное удаленной от этих структур опухолью. Доказано существование относительно устойчивых ассоциаций между формой неврологического синдрома, типом обнаруживаемых у больного антинейрональных антител (АТ) и характером онкопатологии. В то же время патогномоничные сочетания такого рода отсутствуют: одни и те же антитела могут выявляться при разных видах опухолей и при разных синдромах. Кроме того, с каждым годом идентифицируются все новые паранеопластические АТ. В статье представлены обновленные критерии диагностики ПарНС, опубликованные международной группой экспертов в 2021 году. Обсуждаются понятия клинических фенотипов и антител высокого, среднего и низкого рисков. Рассматривается шкала, предложенная для определения уровня достоверности диагноза ПарНС, учитывающая фенотип неврологического расстройства, присутствие определенных антител в сыворотке крови, наличие верифицированной онкопатологии и длительность периода наблюдения за больным.

Paraneoplastic neurological syndromes (PNNS) are neurological disorders due to autoimmune attack on the nervous system, induced by a tumor remote from these structures. The existence of relatively stable associations between the neurological syndrome, the type of antineuronal antibodies (Ab) and the nature of tumor has been proven. At the same time, there are no pathognomonic combinations of this kind: the same antibodies can be detected in diff erent types of tumors and in diff erent syndromes. In addition, level of reliability of the diagnosis of PNNS is considered, taking into account the phenotype of the neurological disorder, the presence of certain antibodies in the blood serum, the verifi cation of oncopathology and the duration of the observation for the patient.

паранеопластические неврологические синдромыклинические фенотипыантинейрональные антителадиагностикаparaneoplastic neurological syndromesclinical phenotypesantineuronal antibodiesdiagnosisReferencesDevine M.F., Kothapalli N., Elkhooly M., Dubey D. Paraneoplastic neurological syndromes: clinical presentations and management. Ther Adv Neurol Disord. 2020;14:1–19. doi: 10.1177/1756286420985323Devine M.F., Kothapalli N., Elkhooly M., Dubey D. Paraneoplastic neurological syndromes: clinical presentations and management. Ther Adv Neurol Disord. 2020;14:1–19. doi: 10.1177/1756286420985323Binks S., Uy C., Honnorat J., Irani S.R. Paraneoplastic neurological syndromes: a practical approach to diagnosis and management. Pract Neurol. 2022;22(1):19–31. doi: 10.1136/practneurol-2021-003073Binks S., Uy C., Honnorat J., Irani S.R. Paraneoplastic neurological syndromes: a practical approach to diagnosis and management. Pract Neurol. 2022;22(1):19–31. doi: 10.1136/practneurol-2021-003073Gilligan M., McGuigan C., McKeon A. Paraneoplastic neurologic disorders. Curr Neurol Neurosci Rep. 2023;23(3):67–82. doi: 10.1007/s11910-023-01250-wGilligan M., McGuigan C., McKeon A. Paraneoplastic neurologic disorders. Curr Neurol Neurosci Rep. 2023;23(3):67–82. doi: 10.1007/s11910-023-01250-wJitprapaikulsan J., Paul P., Thakolwiboon S., Mittal S.O., Pittock S.J., Dubey D. Paraneoplastic neurological syndrome: an evolving story. Neurooncol Pract. 2021;8(4):362–374. doi: 10.1093/nop/npab002Jitprapaikulsan J., Paul P., Thakolwiboon S., Mittal S.O., Pittock S.J., Dubey D. Paraneoplastic neurological syndrome: an evolving story. Neurooncol Pract. 2021;8(4):362–374. doi: 10.1093/nop/npab002Shah S., Flanagan E.P., Paul P., Smith C.Y., Bryant S.C., Devine M.F., Lennon V.A., McKeon A., Pittock S.J., Dubey D. Population-Based Epidemiology Study of Paraneoplastic neurologicsyndromes. Neurol Neuroimmunol Neuroinfl amm. 2021;9(2):e1124. doi: 10.1212/NXI.0000000000001124Shah S., Flanagan E.P., Paul P., Smith C.Y., Bryant S.C., Devine M.F., Lennon V.A., McKeon A., Pittock S.J., Dubey D. Population-Based Epidemiology Study of Paraneoplastic neurologicsyndromes. Neurol Neuroimmunol Neuroinfl amm. 2021;9(2):e1124. doi: 10.1212/NXI.0000000000001124Sechi E., Flanagan E.P. Antibody-Mediated Autoimmune Diseases of the CNS: Challenges and approaches to diagnosis and management. Front Neurol. 2021;12:673339. doi: 10.3389/fneur.2021.673339Sechi E., Flanagan E.P. Antibody-Mediated Autoimmune Diseases of the CNS: Challenges and approaches to diagnosis and management. Front Neurol. 2021;12:673339. doi: 10.3389/fneur.2021.673339Chung C., Allen E., Umoru G. Paraneoplastic syndromes: a focus on pathophysiology and supportive care. Am J Health Syst Pharm. 2022;79(22):1988–2000. doi: 10.1093/ajhp/zxac211Chung C., Allen E., Umoru G. Paraneoplastic syndromes: a focus on pathophysiology and supportive care. Am J Health Syst Pharm. 2022;79(22):1988–2000. doi: 10.1093/ajhp/zxac211Sardiña González C., Martínez Vivero C., López Castro J. Paraneoplastic syndromes review: the great forgotten ones. Crit Rev Oncol Hematol. 2022;174:103676. doi: 10.1016/j.critrevonc.2022.103676Sardiña González C., Martínez Vivero C., López Castro J. Paraneoplastic syndromes review: the great forgotten ones. Crit Rev Oncol Hematol. 2022;174:103676. doi: 10.1016/j.critrevonc.2022.103676Joubert B., Rostásy K., Honnorat J. Immune-mediated ataxias. Handb Clin Neurol. 2018;155:313–332. doi: 10.1016/B978-0-444-64189-2.00021-4Joubert B., Rostásy K., Honnorat J. Immune-mediated ataxias. Handb Clin Neurol. 2018;155:313–332. doi: 10.1016/B978-0-444-64189-2.00021-4Mitoma H., Manto M., Hadjivassiliou M. Immune-mediated cerebellar ataxias: clinical diagnosis and treatment based on immunological and physiological mechanisms. J Mov Disord. 2021;14(1):10–28. doi: 10.14802/jmd.20040Mitoma H., Manto M., Hadjivassiliou M. Immune-mediated cerebellar ataxias: clinical diagnosis and treatment based on immunological and physiological mechanisms. J Mov Disord. 2021;14(1):10–28. doi: 10.14802/jmd.20040Vogrig A., Gigli G.L., Segatti S., Corazza E., Marini A., Bernardini A., Valent F., Fabris M., Curcio F., Brigo F., Iacono D., Passadore P., Rana M., Honnorat J., Valente M. Epidemiology of paraneoplastic neurological syndromes: a population-based study. J Chen Z., Liang Y., Yang H., Cao L., Zhou Y., Zhao Y., Zhang Y. Anti-CV2/CRMP5 antibody-positive paraneoplastic neurological syndromes with chronic intestinal pseudo-obstruction in a small-cell lung cancer patient: a case report and literature review. J Int Med Res. 2020;48(12):300060520974466. doi: 10.1177/030Neurol. 2020;267(1):26–35. doi: 10.1007/s00415-019-09544-1Vogrig A., Gigli G.L., Segatti S., Corazza E., Marini A., Bernardini A., Valent F., Fabris M., Curcio F., Brigo F., Iacono D., Passadore P., Rana M., Honnorat J., Valente M. Epidemiology of paraneoplastic neurological syndromes: a population-based study. J Chen Z., Liang Y., Yang H., Cao L., Zhou Y., Zhao Y., Zhang Y. Anti-CV2/CRMP5 antibody-positive paraneoplastic neurological syndromes with chronic intestinal pseudo-obstruction in a small-cell lung cancer patient: a case report and literature review. J Int Med Res. 2020;48(12):300060520974466. doi: 10.1177/030Neurol. 2020;267(1):26–35. doi: 10.1007/s00415-019-09544-1Yan J., Chen Z., Liang Y., Yang H., Cao L., Zhou Y., Zhao Y., Zhang Y. Anti-CV2/CRMP5 antibody-positive paraneoplastic neurological syndromes with chronic intestinal pseudo-obstruction in a small-cell lung cancer patient: a case report and literature review. J Int Med Res. 2020;48(12):300060520974466. doi: 10.1177/0300060520974466Yan J., Chen Z., Liang Y., Yang H., Cao L., Zhou Y., Zhao Y., Zhang Y. Anti-CV2/CRMP5 antibody-positive paraneoplastic neurological syndromes with chronic intestinal pseudo-obstruction in a small-cell lung cancer patient: a case report and literature review. J Int Med Res. 2020;48(12):300060520974466. doi: 10.1177/0300060520974466Hebert J., Riche B., Vogrig A., Muniz-Castrillo S., Joubert B., Picard G., Rogemond V., Psimaras D., Alentorn A., Berzero G., Desestret V., Rabilloud M, Honnorat J. Epidemiology of paraneoplastic neurologic syndromes and autoimmune encephalitides in France. Neurol Neuroimmunol Neuroinfl amm 2020;7:e883. https://doi.org/10.1212/NXI.0000000000000883Hebert J., Riche B., Vogrig A., Muniz-Castrillo S., Joubert B., Picard G., Rogemond V., Psimaras D., Alentorn A., Berzero G., Desestret V., Rabilloud M, Honnorat J. Epidemiology of paraneoplastic neurologic syndromes and autoimmune encephalitides in France. Neurol Neuroimmunol Neuroinfl amm 2020;7:e883. https://doi.org/10.1212/NXI.0000000000000883Sun X., Tan J., Sun H., Liu Y., Guan W., Jia J., Wang Z. AntiSOX1 antibodies in paraneoplastic neurological syndrome. J Clin Neurol. 2020;16(4):530–546. doi: 10.3988/jcn.2020.16.4.530Sun X., Tan J., Sun H., Liu Y., Guan W., Jia J., Wang Z. AntiSOX1 antibodies in paraneoplastic neurological syndrome. J Clin Neurol. 2020;16(4):530–546. doi: 10.3988/jcn.2020.16.4.530Graus F., Vogrig A., Muñiz-Castrillo S., Antoine J.G., Desestret V., Dubey D., Giometto B., Irani S.R., Joubert B., Leypoldt F., McKeon A., Prüss H., Psimaras D., Thomas L., Titulaer M.J., Vedeler C.A., Verschuuren J.J., Dalmau J., Honnorat J. Updated diagnostic criteria for paraneoplastic neurologic syndromes. Neurol Neuroimmunol Neuroinfl amm. 2021;8(4):e1014. doi: 10.1212/NXI.0000000000001014Graus F., Vogrig A., Muñiz-Castrillo S., Antoine J.G., Desestret V., Dubey D., Giometto B., Irani S.R., Joubert B., Leypoldt F., McKeon A., Prüss H., Psimaras D., Thomas L., Titulaer M.J., Vedeler C.A., Verschuuren J.J., Dalmau J., Honnorat J. Updated diagnostic criteria for paraneoplastic neurologic syndromes. Neurol Neuroimmunol Neuroinfl amm. 2021;8(4):e1014. doi: 10.1212/NXI.0000000000001014Kunchok A., McKeon A., Zekeridou A., Flanagan E.P., Dubey D., Lennon V.A., Klein C.J., Mills J.R., Pittock S.J. Autoimmune/ paraneoplastic encephalitis antibody biomarkers: frequency, age, and sex associations. Mayo Clin Proc. 2022;97(3):547–559. doi: 10.1016/j.mayocp.2021.07.023Kunchok A., McKeon A., Zekeridou A., Flanagan E.P., Dubey D., Lennon V.A., Klein C.J., Mills J.R., Pittock S.J. Autoimmune/ paraneoplastic encephalitis antibody biomarkers: frequency, age, and sex associations. Mayo Clin Proc. 2022;97(3):547–559. doi: 10.1016/j.mayocp.2021.07.023Frykman H., Kumar P. An opinion on the clinical laboratory testing following the new 2021 PNS-Care diagnostic criteria. J Appl Lab Med. 2022;7(1):367–372. doi: 10.1093/jalm/jfab154Frykman H., Kumar P. An opinion on the clinical laboratory testing following the new 2021 PNS-Care diagnostic criteria. J Appl Lab Med. 2022;7(1):367–372. doi: 10.1093/jalm/jfab154Loehrer P.A., Zieger L., Simon O.J. Update on paraneoplastic cerebellar degeneration. Brain Sci. 2021;11(11):1414. doi: 10.3390/brainsci11111414Loehrer P.A., Zieger L., Simon O.J. Update on paraneoplastic cerebellar degeneration. Brain Sci. 2021;11(11):1414. doi: 10.3390/brainsci11111414Давыдовская М.В., Бойко А.Н., Беляева И.А., Мартынов М.Ю., Гусев Е.И. Аутоиммунные энцефалиты. Журнал неврологии и психиатрии им. С.С.Корсакова. 2015;115(4):95–101. doi: 10.17116/jnevro20151154195-101Davydovskaya M.V., Boĭko A.N., Beliaeva I.A., Martynov M.Iu., Gusev E.I. Autoimmune encephalitis. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2015;115(4):95–101. (In Russ.)]. doi: 10.17116/jnevro20151154195-101Dubey D., Wilson M.R., Clarkson B., Giannini C., Gandhi M., Cheville J., Lennon V.A., Eggers S., Devine M.F., MandelBrehm C., Kryzer T., Hinson S.R., Khazaie K., Hales C., Kattah J., Pavelko K.D., Andrews P., Eaton J.E., Jitprapaikulsan J., Mills J.R., Flanagan E.P., Zekeridou A., Leibovich B., Fryer J., Torre M., Kaufman C., Thoreson J.B., Sagen J., Linnoila J.J., DeRisi J.L., Howe C.L., McKeon A., Pittock S.J. Expanded clinical phenotype, oncological associations, and immunopathologic insights of paraneoplastic Kelch-like protein-11 encephalitis. JAMA Neurol. 2020;77(11):1420–1429. doi: 10.1001/jamaneurol.2020.2231Dubey D., Wilson M.R., Clarkson B., Giannini C., Gandhi M., Cheville J., Lennon V.A., Eggers S., Devine M.F., MandelBrehm C., Kryzer T., Hinson S.R., Khazaie K., Hales C., Kattah J., Pavelko K.D., Andrews P., Eaton J.E., Jitprapaikulsan J., Mills J.R., Flanagan E.P., Zekeridou A., Leibovich B., Fryer J., Torre M., Kaufman C., Thoreson J.B., Sagen J., Linnoila J.J., DeRisi J.L., Howe C.L., McKeon A., Pittock S.J. Expanded clinical phenotype, oncological associations, and immunopathologic insights of paraneoplastic Kelch-like protein-11 encephalitis. JAMA Neurol. 2020;77(11):1420–1429. doi: 10.1001/jamaneurol.2020.2231Dubey D., Jitprapaikulsan J., Bi H., Do Campo R.V., McKeon A., Pittock S.J., Engelstad J.K., Mills J.R., Klein C.J. AmphiphysinIgG autoimmune neuropathy: a recognizable clinicopathologic syndrome. Neurology. 2019;93(20):e1873–e1880.doi: 10.1212/WNL.0000000000008472Dubey D., Jitprapaikulsan J., Bi H., Do Campo R.V., McKeon A., Pittock S.J., Engelstad J.K., Mills J.R., Klein C.J. AmphiphysinIgG autoimmune neuropathy: a recognizable clinicopathologic syndrome. Neurology. 2019;93(20):e1873–e1880.doi: 10.1212/WNL.0000000000008472Li L., Guo Y., Wang J. Detection of paraneoplastic antibodies and their signifi cance in paraneoplastic neurologic syndromes: a narrative review. Ann Transl Med. 2023;11(7):283. doi: 10.21037/atm-21-2434Li L., Guo Y., Wang J. Detection of paraneoplastic antibodies and their signifi cance in paraneoplastic neurologic syndromes: a narrative review. Ann Transl Med. 2023;11(7):283. doi: 10.21037/atm-21-2434Erdil Yucesoy E., Tunc H., Erdem S.N., Bozkurt S., Tuncer N. Limbic encephalitis with dual positivity. Cureus. 2023;15(6):e40399. doi: 10.7759/cureus.40399Erdil Yucesoy E., Tunc H., Erdem S.N., Bozkurt S., Tuncer N. Limbic encephalitis with dual positivity. Cureus. 2023;15(6):e40399. doi: 10.7759/cureus.40399Flanagan E.P., Geschwind M.D., Lopez-Chiriboga A.S., Blackburn K.M., Turaga S., Binks S., Zitser J., Gelfand J.M., Day G.S., Dunham S.R., Rodenbeck S.J., Clardy S.L., Solomon A.J., Pittock S.J., McKeon A., Dubey D., Zekeridou A., Toledano M., Turner L.E., Vernino S., Irani S.R. Autoimmune encephalitis/ misdiagnosis in adults. JAMA Neurol. 2023;80(1):30–39. doi: 10.1001/jamaneurol.2022.4251Flanagan E.P., Geschwind M.D., Lopez-Chiriboga A.S., Blackburn K.M., Turaga S., Binks S., Zitser J., Gelfand J.M., Day G.S., Dunham S.R., Rodenbeck S.J., Clardy S.L., Solomon A.J., Pittock S.J., McKeon A., Dubey D., Zekeridou A., Toledano M., Turner L.E., Vernino S., Irani S.R. Autoimmune encephalitis/ misdiagnosis in adults. JAMA Neurol. 2023;80(1):30–39. doi: 10.1001/jamaneurol.2022.4251Zoccarato M., Grisold W., Grisold A., Poretto V., Boso F., Giometto B. Paraneoplastic neuropathies: What’s new since the 2004 recommended diagnostic criteria. Front Neurol. 2021;12:706169. doi: 10.3389/fneur.2021.706169Zoccarato M., Grisold W., Grisold A., Poretto V., Boso F., Giometto B. Paraneoplastic neuropathies: What’s new since the 2004 recommended diagnostic criteria. Front Neurol. 2021;12:706169. doi: 10.3389/fneur.2021.706169Сохацкая Ю.М., Васькова Н.Л., Субботина Д.Р., Чистова И.В., Сулин К.А., Красношлык П.В., Гуляев Д.А. Анти-YO энцефалит: клинический случай и литературный обзор. МЕДЛАЙН. РУ. 2022;23(48):792–800. http://www.medline.ru/public/art/tom23/art48.htmlSokhatskaya Yu.M., Vaskova N.L., Subbotina D.R., Chistova I.V., Sulin K.A., Krasnoshlyk P.V., Gulyaev D.A. Anti-YO encephalitis: case report and literature review. MEDLINE.RU. 2022;23(48):792–800. (In Russ.)]. http://www.medline.ru/public/art/tom23/art48.htmlHerdlevær I., Haugen M., Mazengia K., Totland C., Vedeler C. Paraneoplastic cerebellar degeneration: the importance of including CDR2L as a diagnostic marker . Neurol Neuroimmunol Neuroinfl amm. 2021;8(2):e963. doi: 10.1212/NXI.0000000000000963Herdlevær I., Haugen M., Mazengia K., Totland C., Vedeler C. Paraneoplastic cerebellar degeneration: the importance of including CDR2L as a diagnostic marker . Neurol Neuroimmunol Neuroinfl amm. 2021;8(2):e963. doi: 10.1212/NXI.0000000000000963Нужный Е.П., Краснов М.Ю., Москаленко А.Н., Федотова Е.Ю., Чеканова Е.О., Иллариошкин С.Н. Паранеопластическая мозжечковая дегенерация. Российский неврологический журнал. 2023;28(4):43–53. https://doi.org/10.30629/2658-7947-2023-28-4-43-53Nuzhnyi E.P., Krasnov M.Yu., Moskalenko A.N., Fedotova E.Yu., Chekanova E.O., Illarioshkin S.N. Paraneoplastic cerebellar degeneration. Russian neurological journal. 2023;28(4):43–53. (In Russ.)]. https://doi.org/10.30629/2658-7947-2023-28-4-43-53Greenlee J., Brashear H.R. The discovery of anti-Yo (Anti-PCA1) antibody in patients with paraneoplastic cerebellar degeneration: opening a window into autoimmune neurological disease. Cerebellum. 2023;22(4):531–533. doi: 10.1007/s12311-022-01446-9Greenlee J., Brashear H.R. The discovery of anti-Yo (Anti-PCA1) antibody in patients with paraneoplastic cerebellar degeneration: opening a window into autoimmune neurological disease. Cerebellum. 2023;22(4):531–533. doi: 10.1007/s12311-022-01446-9Graus F., Dalmau J., Valldeoriola F., Ferrer I., Reñe R., Marin C., Vecht C.J., Arbizu T., Targa C., Moll J.W. Immunological characterization of a neuronal antibody (anti-Tr) associated with paraneoplastic cerebellar degeneration and Hodgkin’s disease. J Neuroimmunol 1997;74(1–2):55–61. doi: 10.1016/s0165-5728(96)00205-6Graus F., Dalmau J., Valldeoriola F., Ferrer I., Reñe R., Marin C., Vecht C.J., Arbizu T., Targa C., Moll J.W. Immunological characterization of a neuronal antibody (anti-Tr) associated with paraneoplastic cerebellar degeneration and Hodgkin’s disease. J Neuroimmunol 1997;74(1–2):55–61. doi: 10.1016/s0165-5728(96)00205-6Tazi R., Salimi Z., Fadili H., Aasfara J., Hazim A. Anti-Ri-associated paraneoplastic neurological syndrome revealing breast cancer: A case report. Cureus. 2022;14(1):e21106. doi: 10.7759/cureus.21106Tazi R., Salimi Z., Fadili H., Aasfara J., Hazim A. Anti-Ri-associated paraneoplastic neurological syndrome revealing breast cancer: A case report. Cureus. 2022;14(1):e21106. doi: 10.7759/cureus.21106Luque F.A., Furneaux H.M., Ferziger R., Rosenblum M.K., Wray S.H., Schold S.C.Jr., Glantz M.J., Jaeckle K.A., Biran H., Lesser M., Paulsen W.A., River M.E., Posner Dr J.B. Anti-Ri: an antibody associated with paraneoplastic opsoclonus and breast cancer. Ann Neurol. 1991;29(3):241–51. doi: 10.1002/ana.410290303Luque F.A., Furneaux H.M., Ferziger R., Rosenblum M.K., Wray S.H., Schold S.C.Jr., Glantz M.J., Jaeckle K.A., Biran H., Lesser M., Paulsen W.A., River M.E., Posner Dr J.B. Anti-Ri: an antibody associated with paraneoplastic opsoclonus and breast cancer. Ann Neurol. 1991;29(3):241–51. doi: 10.1002/ana.410290303Maudes E., Landa J., Muñoz-Lopetegi A., Armangue T., Alba M., Saiz A., Graus F., Dalmau J., Sabater L. Clinical signifi cance of Kelch-like protein 11 antibodies. Neurol Neuroimmunol Neuroinfl amm. 2020;7(3):e666. doi: 10.1212/NXI.0000000000000666Maudes E., Landa J., Muñoz-Lopetegi A., Armangue T., Alba M., Saiz A., Graus F., Dalmau J., Sabater L. Clinical signifi cance of Kelch-like protein 11 antibodies. Neurol Neuroimmunol Neuroinfl amm. 2020;7(3):e666. doi: 10.1212/NXI.0000000000000666Narayan R.N., McKeon A., Fife T.D. Autoimmune vestibulocerebellar syndromes. Semin Neurol. 2020;40(1):97–115. doi: 10.1055/s-0039-3402061Narayan R.N., McKeon A., Fife T.D. Autoimmune vestibulocerebellar syndromes. Semin Neurol. 2020;40(1):97–115. doi: 10.1055/s-0039-3402061Ortega Suero G., Sola-Valls N., Escudero D., Saiz A., Graus F. Anti-Ma and anti-Ma2-associated paraneoplastic neurological syndromes. Neurologia (Engl Ed). 2018;33(1):18–27. doi: 10.1016/j.nrl.2016.05.010 Epub 2016 Jul 25.Ortega Suero G., Sola-Valls N., Escudero D., Saiz A., Graus F. Anti-Ma and anti-Ma2-associated paraneoplastic neurological syndromes. Neurologia (Engl Ed). 2018;33(1):18–27. doi: 10.1016/j.nrl.2016.05.010 Epub 2016 Jul 25.Gadoth A., Kryzer T.J., Fryer J., McKeon A., Lennon V.A., Pittock S.J. Microtubule-associated protein 1B: novel paraneoplastic biomarker. Ann Neurol. 2017;81(2):266–277. doi: 10.1002/ana.24872Gadoth A., Kryzer T.J., Fryer J., McKeon A., Lennon V.A., Pittock S.J. Microtubule-associated protein 1B: novel paraneoplastic biomarker. Ann Neurol. 2017;81(2):266–277. doi: 10.1002/ana.24872Saint-Martin M., Joubert B., Pellier-Monnin V., Pascual O., Noraz N., Honnorat J. Contactin-associated protein-like 2, a protein of the neurexin family involved in several human diseases. Eur J Neurosci. 2018;48(3):1906–1923. doi: 10.1111/ejn.14081Saint-Martin M., Joubert B., Pellier-Monnin V., Pascual O., Noraz N., Honnorat J. Contactin-associated protein-like 2, a protein of the neurexin family involved in several human diseases. Eur J Neurosci. 2018;48(3):1906–1923. doi: 10.1111/ejn.14081Boyko M., Au K.L.K., Casault C., de Robles P., Pfeff er G. Systematic review of the clinical spectrum of CASPR2 antibody syndrome. J Neurol. 2020;267(4):1137–1146. doi: 10.1007/s00415-019-09686-2Boyko M., Au K.L.K., Casault C., de Robles P., Pfeff er G. Systematic review of the clinical spectrum of CASPR2 antibody syndrome. J Neurol. 2020;267(4):1137–1146. doi: 10.1007/s00415-019-09686-2Evenseth L.S.M., Gabrielsen M., Sylte I. The GABAB receptor-structure, ligand binding and drug development. Molecules. 2020;25(13):3093. doi: 10.3390/molecules25133093Evenseth L.S.M., Gabrielsen M., Sylte I. The GABAB receptor-structure, ligand binding and drug development. Molecules. 2020;25(13):3093. doi: 10.3390/molecules25133093Shaye H., Stauch B., Gati C., Cherezov V. Molecular mechanisms of metabotropic GABAB receptor function. Sci Adv. 2021;7(22):eabg3362. doi: 10.1126/sciadv.abg3362Shaye H., Stauch B., Gati C., Cherezov V. Molecular mechanisms of metabotropic GABAB receptor function. Sci Adv. 2021;7(22):eabg3362. doi: 10.1126/sciadv.abg3362Павлова О.В., Павлов К.А., Мурашко А.А., Гурина О.И., Шмуклер А.Б. NMDA-рецепторы, антитела к ним и их роль при различных психических и нейровоспалительных заболеваниях. Молекулярная медицина. 2021;19(1):3–10. https://doi.org/10.29296/24999490-2021-01-01Pavlova O.V., Pavlov K.A., Murashko A.A., Gurina O.I., Shmukler A.B. NMDA receptors, anti-NMDA receptor antibodies and their role in psychiatric and neuroinfl ammatory disorders. Molekulyarnaya meditsina. 2021;19(1):3–10. (In Russ.)]. https://doi.org/10.29296/24999490-2021-01-01Winklehner M., Bauer J., Endmayr V., Schwaiger C., Ricken G., Motomura M., Yoshimura S., Shintaku H., Ishikawa K., Tsuura Y., Iizuka T., Yokota T., Irioka T., Höftberger R. Paraneoplastic cerebellar degeneration with P/Q-VGCC vs Yo autoantibodies. Neurol Neuroimmunol Neuroinfl amm. 2022;9(4):e200006. doi: 10.1212/NXI.0000000000200006Winklehner M., Bauer J., Endmayr V., Schwaiger C., Ricken G., Motomura M., Yoshimura S., Shintaku H., Ishikawa K., Tsuura Y., Iizuka T., Yokota T., Irioka T., Höftberger R. Paraneoplastic cerebellar degeneration with P/Q-VGCC vs Yo autoantibodies. Neurol Neuroimmunol Neuroinfl amm. 2022;9(4):e200006. doi: 10.1212/NXI.0000000000200006Benoit J., Muñiz-Castrillo S., Vogrig A., Farina A., Pinto A.L., Picard G., Rogemond V., Guery D., Alentorn A., Psimaras D., Rheims S., Honnorat J., Joubert B. Early-stage ContactinAssociated Protein-like 2 limbic encephalitis. Neurol Neuroimmunol Neuroinfl amm. 2022;10(1):e200041. doi: 10.1212/NXI.0000000000200041Benoit J., Muñiz-Castrillo S., Vogrig A., Farina A., Pinto A.L., Picard G., Rogemond V., Guery D., Alentorn A., Psimaras D., Rheims S., Honnorat J., Joubert B. Early-stage ContactinAssociated Protein-like 2 limbic encephalitis. Neurol Neuroimmunol Neuroinfl amm. 2022;10(1):e200041. doi: 10.1212/NXI.0000000000200041Braczkowski M., Soszyński D., Sierakowska A., Braczkowski R., Kufel K., Łabuz-Roszak B. Autoimmune encephalitis with antibodies: anti-NMDAR, anti-AMPAR, anti-GQ1b, antiDPPX, anti-CASPR2, anti-LGI1, anti-RI, anti-Yo, anti-Hu, antiCV2 and anti-GABAAR, in the course of psychoses, neoplastic diseases, and paraneoplastic syndromes. Diagnostics (Basel). 2023;13(15):2589. doi: 10.3390/diagnostics13152589Braczkowski M., Soszyński D., Sierakowska A., Braczkowski R., Kufel K., Łabuz-Roszak B. Autoimmune encephalitis with antibodies: anti-NMDAR, anti-AMPAR, anti-GQ1b, antiDPPX, anti-CASPR2, anti-LGI1, anti-RI, anti-Yo, anti-Hu, antiCV2 and anti-GABAAR, in the course of psychoses, neoplastic diseases, and paraneoplastic syndromes. Diagnostics (Basel). 2023;13(15):2589. doi: 10.3390/diagnostics13152589Nguyen L., Wang C. Anti-NMDA receptor autoimmune encephalitis: diagnosis and management strategies. Int J Gen Med. 2023;16:7–21. doi: 10.2147/IJGM.S397429Nguyen L., Wang C. Anti-NMDA receptor autoimmune encephalitis: diagnosis and management strategies. Int J Gen Med. 2023;16:7–21. doi: 10.2147/IJGM.S397429Uy C.E., Binks S., Irani S.R. Autoimmune encephalitis: clinical spectrum and management. Pract Neurol. 2021;21(5):412–423. doi: 10.1136/practneurol-2020-002567Uy C.E., Binks S., Irani S.R. Autoimmune encephalitis: clinical spectrum and management. Pract Neurol. 2021;21(5):412–423. doi: 10.1136/practneurol-2020-002567Budhram A., Leung A., Nicolle M.W, Burneo J.G. Diagnosing autoimmune limbic encephalitis. CMAJ. 2019;191(19):E529–E534. doi: 10.1503/cmaj.181548Budhram A., Leung A., Nicolle M.W, Burneo J.G. Diagnosing autoimmune limbic encephalitis. CMAJ. 2019;191(19):E529–E534. doi: 10.1503/cmaj.181548Ding J.B., Dongas J., Hu K., Ding M. Autoimmune limbic encephalitis: a review of clinicoradiological features and the challenges of diagnosis. Cureus. 2021;13(8):e17529. doi: 10.7759/cureus.17529Ding J.B., Dongas J., Hu K., Ding M. Autoimmune limbic encephalitis: a review of clinicoradiological features and the challenges of diagnosis. Cureus. 2021;13(8):e17529. doi: 10.7759/cureus.17529Marsili L., Marcucci S., LaPorta J., Chirra M., Espay A.J., Colosimo C. Paraneoplastic neurological syndromes of the central nervous system: pathophysiology, diagnosis, and treatment. Biomedicines. 2023;11(5):1406. doi: 10.3390/biomedicines11051406Marsili L., Marcucci S., LaPorta J., Chirra M., Espay A.J., Colosimo C. Paraneoplastic neurological syndromes of the central nervous system: pathophysiology, diagnosis, and treatment. Biomedicines. 2023;11(5):1406. doi: 10.3390/biomedicines11051406Klötzsch C., Böhmert M., Hermann R., Teegen B., Rentzsch K., Till А. Anti-Homer-3 antibodies in cerebrospinal fl uid and serum samples from a 58-year-old woman with subacute cerebellar degeneration and diff use breast adenocarcinoma. Neurol. Res. Pract.2022;4(1):29. https://doi.org/10.1186/s42466-022-00194-9Klötzsch C., Böhmert M., Hermann R., Teegen B., Rentzsch K., Till А. Anti-Homer-3 antibodies in cerebrospinal fl uid and serum samples from a 58-year-old woman with subacute cerebellar degeneration and diff use breast adenocarcinoma. Neurol. Res. Pract.2022;4(1):29. https://doi.org/10.1186/s42466-022-00194-9Martins L., Galvão D., Silva A., Vieira B., Reis Ó., Vitorino R., Pires P. Paraneoplastic opsoclonus-myoclonus syndrome as a rare presentation of breast cancer. J Surg Case Rep. 2019;2019(2):rjy365. doi: 10.1093/jscr/rjy365Martins L., Galvão D., Silva A., Vieira B., Reis Ó., Vitorino R., Pires P. Paraneoplastic opsoclonus-myoclonus syndrome as a rare presentation of breast cancer. J Surg Case Rep. 2019;2019(2):rjy365. doi: 10.1093/jscr/rjy365Kostoglou A., Vlastos D., Bakalis A., Ghosh D. Breast cancer-associated opsoclonus-myoclonus syndrome: a case report. World J Surg Oncol. 2021;19(1):328. doi: 10.1186/s12957-021-02436-7Kostoglou A., Vlastos D., Bakalis A., Ghosh D. Breast cancer-associated opsoclonus-myoclonus syndrome: a case report. World J Surg Oncol. 2021;19(1):328. doi: 10.1186/s12957-021-02436-7Санадзе А.Г., Сиднев Д.В., Тумуров Д.А. Серонегативный непаранеопластический миастенический синдром Ламберта– Итона. Журнал неврологии и психиатрии им. С.С. Корсакова. 2017;117(5):77–80. https://doi.org/10.17116/jnevro20171175177-80Sanadze A.G., Sidnev D.V., Tumurov D.A. Seronegative nonparaneoplastic Lambert–Eaton myasthenic syndrome. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2017;117(5):77–80. (In Russ.)]. https://doi.org/10.17116/jnevro20171175177-80Hong B.Y., An H.J., Lim S.H. Long-standing Lambert-Eaton Myasthenic Syndrome Caused by Undetectable Small-Cell Lung Cancer: why we should follow-up LEMS. Diagnostics (Basel). 2022;12(7):1542. doi: 10.3390/diagnostics12071542Hong B.Y., An H.J., Lim S.H. Long-standing Lambert-Eaton Myasthenic Syndrome Caused by Undetectable Small-Cell Lung Cancer: why we should follow-up LEMS. Diagnostics (Basel). 2022;12(7):1542. doi: 10.3390/diagnostics12071542Панченко Н.И., Шулешова Н.В., Руденко Д.И., Скулябин Д.И., Колчев С.А., Перфильев С.В., Лапин С.В. Аутоиммунный анти-NMDA-энцефалит, ассоциированный с новой коронавирусной инфекцией COVID-19. Российский неврологический журнал. 2023;28(4):60–67. https://doi.org/10.30629/2658-7947-2023-28-4-60-67Panchenko N.I., Shuleshova N.V., Rudenko D.I., Skulyabin D.I., Kolchev S.A., Perfi lev S.V., Lapin S.V. Autoimmune аnti-NMDA encephalitis associated with the new coronavirus infection COVID-19. Russian neurological journal. 2023;28(4):60–67. (In Russ.)]. https://doi.org/10.30629/2658-7947-2023-28-4-60-67Chefdeville A., Treilleux I., Mayeur M.E., Couillault C., Picard G., Bost C., Mokhtari K., Vasiljevic A., Meyronet D., Rogemond V., Psimaras D., Dubois B., Honnorat J., Desestret V. Immunopathological characterization of ovarian teratomas associated with anti-N-methyl-D-aspartate receptor encephalitis. Acta Neuropathol Commun. 2019;7(1):38. doi: 10.1186/s40478-019-0693-7Chefdeville A., Treilleux I., Mayeur M.E., Couillault C., Picard G., Bost C., Mokhtari K., Vasiljevic A., Meyronet D., Rogemond V., Psimaras D., Dubois B., Honnorat J., Desestret V. Immunopathological characterization of ovarian teratomas associated with anti-N-methyl-D-aspartate receptor encephalitis. Acta Neuropathol Commun. 2019;7(1):38. doi: 10.1186/s40478-019-0693-7Muñiz-Castrillo S., Joubert B., Elsensohn M.H., Pinto A.L., Saint-Martin M., Vogrig A., Picard G., Rogemond V., Dubois V., Tamouza R., Maucort-Boulch D., Honnorat J. Anti-CASPR2 clinical phenotypes correlate with HLA and immunological features. J Neurol Neurosurg Psychiatry. 2020;91(10):1076–1084. doi: 10.1136/jnnp-2020-323226Muñiz-Castrillo S., Joubert B., Elsensohn M.H., Pinto A.L., Saint-Martin M., Vogrig A., Picard G., Rogemond V., Dubois V., Tamouza R., Maucort-Boulch D., Honnorat J. Anti-CASPR2 clinical phenotypes correlate with HLA and immunological features. J Neurol Neurosurg Psychiatry. 2020;91(10):1076–1084. doi: 10.1136/jnnp-2020-323226Dade M., Berzero G., Izquierdo C., Giry M., Benazra M., Delattre J.Y., Psimaras D., Alentorn A. Neurological syndromes associated with anti-GAD antibodies. Int J Mol Sci. 2020;21(10):3701. doi: 10.3390/ijms21103701Dade M., Berzero G., Izquierdo C., Giry M., Benazra M., Delattre J.Y., Psimaras D., Alentorn A. Neurological syndromes associated with anti-GAD antibodies. Int J Mol Sci. 2020;21(10):3701. doi: 10.3390/ijms21103701Zhang C., Dai Y., Han B., Peng J., Ma J., Tang Q., Yang L. A case of anti-GAD 65 autoimmune encephalitis associated with focal segmental stiff -person syndrome. Brain Sci. 2023;13(2):369. doi: 10.3390/brainsci13020369Zhang C., Dai Y., Han B., Peng J., Ma J., Tang Q., Yang L. A case of anti-GAD 65 autoimmune encephalitis associated with focal segmental stiff -person syndrome. Brain Sci. 2023;13(2):369. doi: 10.3390/brainsci13020369Parillo M., Quattrocchi C.C., Pilato F., Di Lazzaro V., Beomonte Zobel B. Whole-body computed tomography as fi rst-line imaging procedure to exclude cancer in patients with neurological suspicion of paraneoplastic syndromes: shall clinical practice adhere to recommendations? Radiography (Lond). 2023;29(1):8–13. doi: 10.1016/j.radi.2022.09.001Parillo M., Quattrocchi C.C., Pilato F., Di Lazzaro V., Beomonte Zobel B. Whole-body computed tomography as fi rst-line imaging procedure to exclude cancer in patients with neurological suspicion of paraneoplastic syndromes: shall clinical practice adhere to recommendations? Radiography (Lond). 2023;29(1):8–13. doi: 10.1016/j.radi.2022.09.001

The authors declare that there are no conflicts of interest present.