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Neurol India. 2020 Mar 19. doi: 10.4103/0028-3886.280647. [Epub ahead of print]

Tumors Masquerading as Neurological Diseases: A Caution for Clinicians in Planning Diagnosis and Treatment.

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Department of Pediatrics Surgery, Govt TD Medical College, Alapuzha, Kerala, India.
Department of Neurology, NIMHANS, Bangalore, Karnataka, India.
Sri Avittam Thirunal Hospital, Medical College, Trivandrum, Kerala, India.
Department of Radiology, NIMHANS, Bangalore, Karnataka, India.



Neurological diseases can be due to direct diseases of the central nervous system (CNS) or peripheral nervous system (PNS) or be a bystander syndrome of systemic diseases. Treatment options depend on the cause. Toxic, metabolic and nutritional, and immune-mediated consequences of clinically occult neoplasms produce a spectrum of neurological diseases, recognition of which has therapeutic and prognostic importance.

Patients and Methods:

Children, as well as adults who presented to the authors in the last 5 years with neurological diseases and later their diseases could be diagnosed or attributed to neoplasms which were occult, were included for the study.


28 patients were seen by the authors in the last 5 years with neurological manifestation and hidden tumor. Maximum incidence was in the age of above 60 years followed by the age group of 21-40 years. The commonest neurological presentation was muscle and nerve in adults and seizure in children.


Short duration, rapid progression, severe weight loss, and poor response to treatment given for nontumor associated neurological syndrome are the red flags which point to the diagnosis.


Seizures and psychosis formed the commonest features in children, muscle and nerve in adults. Short duration, rapid progression, and resistance to treatment are the markers for possible underlying neoplasm.


Mass lesions; TRIAD; prognostic and therapeutic relevance; treatment-resistant neurology

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