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To the Editor:Motor neuron disease (MND) is marked by upper (UMN) or lower (LMN) motor neuron signs and symptoms,[1] which in various combinations form the basis for MND classification.In this regard,amyotrophic lateral sclerosis (ALS) is the most common subtype[2] Although otherwise deemed an untreatable degenerative disease,there is now increasing evidence of more heterogeneous pathogenesis,signaling a link between MND and paraneoplastic syndromes.[3]