目的探讨以神经系统表现为首发症状的肺癌的临床特点、误诊疾病及误诊原因。方法对21例神经症状首发的肺癌患者进行临床分析。结果以脑转移引起的偏瘫、头痛、呕吐为首发症状者最多,其次为声音嘶哑、肌萎缩,易误诊为脑肿瘤、脑卒中、肌萎缩侧索硬化症等。结论首发神经症状的肺癌易误诊,应完善检查,拓宽诊断思路,以免延误肺癌的诊断和治疗。 Objective To investigate the clinical features, misdiagnosis and misdiagnosis of lung cancer with neurological manifestations as the first symptom. Methods Twenty-one patients with lung cancer who developed neurological symptoms were analyzed. Results Hemiplegia, headache and vomiting caused by cerebral metastasis were the most common symptom, followed by hoarseness, muscle atrophy and misdiagnosis as brain tumor, stroke, amyotrophic lateral sclerosis and so on. Conclusion The first neurological symptoms of lung cancer are misdiagnosed, and the examination should be perfected to broaden the diagnostic thinking so as to avoid delay in the diagnosis and treatment of lung cancer.