PNS Diagnostic Consensus Criteria

The PNS-Care panel initially consisted of 14 investigators from 8 different countries; all members of the panel are neurologists with clinical and research expertise in PNS and related syndromes. The panel started with the premise that revised consensus diagnostic criteria for PNS were required to improve clinical care and support research. The group established 3 levels of certainty in the diagnosis of PNS (i.e., possible, probable, and definite PNS) according to the coherence between clinical phenotype, antibody, and cancer. In assessing the diagnostic process, the panel reviewed the experience and caveats with detection and interpretation of neuronal antibodies. In addition, new recommendations were considered for neurologic syndromes developing in the context of ICI treatment. It was agreed that several neurologic disorders that can occur in association with cancer are not included in the current diagnostic criteria, such as inflammatory myopathies (dermatomyositis, polymyositis, and necrotizing myopathies), myasthenia gravis, polyneuropathies associated with monoclonal gammopathies, and paraneoplastic retinopathy, optic neuritis, and cochlea-vestibulopathy. Well-designed diagnostic criteria already exist for most of these entities, which are historically not included within the spectrum of PNS.
An initial draft of the guidelines was discussed during the inaugural meeting in Lyon (France) and subsequently underwent several iterations via electronic communication. The last version was then sent to all 14 members, in addition to 5 additional international experts, for final review and comment. All 19 PNS-Care panel members endorsed the final guidelines.