Neuro-otological paraneoplastic syndromes: A new neuroimmunological differential diagnosis

Paraneoplastic neurological syndromes (PNS) originate from immune-mediated neuronal degeneration caused by antibodies raised against tumor cells. Symptoms are progressive and may include cochleovestibulopathy. Vestibular syndromes and neuro-otological symptoms are very common in clinical practice, but their possible paraneoplastic cause is still not well discussed. There are reports in the literature in which auditory and vestibular impairments were identified in patients with small cell lung carcinoma, thymoma, lymphoma, and renal neoplasm. Therefore, these symptoms may provide early evidence of hidden malignancies for which a timely diagnosis is crucial. The present paper discusses available reports of neuro-otological syndromes for which investigation revealed a paraneoplastic cause that, although rare, should be considered in the differential diagnosis.