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Paraneoplastic syndromes, defined in this book as "disorders caused by cancer, but not a direct result of cancer invasion of the affected organ or tissue", once believed to be rare and esoteric neurologic disorders have assumed increasing importance as an explanation of neurologic and other symptoms in patients suffered from occult or controllable cancers. This book attempts a comprehensive review of paraneoplastic syndromes from considering both clinical and pathophysiologic aspects. The book is divided into 4 sections: The first is an overview, classifying the disorders, describing a clinical approach to the diagnosis and treatment of paraneoplastic syndromes in general and identifying their pathogenesis. The second section discusses the clinical findings and treatment of individual paraneoplastic syndromes with chapters dedicated to each of the neurologic syndromes and a chapter discussing nonneurologic syndromes such as endocrine, cutaneous, and rheumatologic paraneoplastic disorders. The third section discusses autoantibodies that characterize individual paraneoplastic syndromes. The final section discusses the paraneoplastic syndromes associated with individual cancers.
Plum and Posner's Diagnosis and Treatment of Stupor and Coma, 5th edition, is a major update of the classic work on diagnosing the cause of coma, with the addition of completely new sections on treatment of comatose patients, by Dr. Jan Claassen, the Director of the Neuro-ICU at Columbia New York Presbyterian Hospital. The first chapter of the book provides an up-to-date review on the brain mechanisms that maintain a conscious state in humans, and how lesions that damage these mechanisms cause loss of consciousness or coma. The second chapter reviews the neurological examination of the comatose patient, which provides the basis for determining whether the patient is suffering from a structural brain injury causing the coma, or from a metabolic disorder of consciousness. The third and fourth chapters review the pathophysiology of structural lesions causing coma, and the specific disease states that result in coma. Chapter five is a comprehensive treatment of the many causes of metabolic coma. Chapter 6 review psychiatric causes of unresponsiveness and how to identify and treat them. Chapters 7 and 8 review the overall emergency treatment of comatose patients, followed by the treatment of specific causes of coma. Chapter 9 examines the long term outcomes of coma, including the minimally conscious state and the persistent vegetative state, and how they can be distinguished, and their implications for eventual useful recovery. Chapter 10 reviews the topic of brain death and the standards for examination of a patient that are required to make the determination of brain death. The final chapter 11 is by J.J. Fins, a medical ethicist who was invited by the other authors to write an essay on the ethics of diagnosis and treatment of patients who, by definition, have no way to approve of or communicate about their wishes. While providing detailed background for neurological and neurosurgical specialists, the practical nature of the material in this book has found its greatest use among Internists, Emergency Medicine, and Intensive Care specialists, who deal with comatose patients frequently, but who may not have had extensive neurological training.
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