Walsh & Hoyt: Carcinomatous Neuromyopathy

Historically, the term carcinomatous neuromyopathy was once used to describe all remote effects of cancer affecting the peripheral nervous system that caused weakness. As the identification of specific paraneoplastic disorders affecting the peripheral nerves, neuromuscular junction, and skeletal muscles became better characterized, this term became obsolete. Still, there exists a group of patients who experience subacute onset of weakness, usually affecting the proximal muscles of the legs more so than the arms who have depressed or absent muscle stretch reflexes and other findings of a peripheral neuropathy and whose physical findings and diagnostic studies do not fulfill criteria for inclusion into one of the peripheral nerve disorders discussed above. Some investigators believed that this condition occurs from the effects of malnutrition and the cachectic state associated with cancer, but there is electrophysiologic and pathologic evidence that this disorder is a neuropathy caused by damage to intramuscular distal axons.