Cancer neurologic complications

Brain metastasis is the most common neurologic complication seen in patients with cancer. Approximately 170,000 patients develop brain metastases in the United States each year.20 Many malignancies are frequently associated with brain metastases (Table 96-7). While melanoma is the tumor type most likely to metastasize to the brain, brain metastases owing to lung and breast cancers are seen more often because they are among the most common cancers. In addition, brain metastasis may be diagnosed at the same time as the primary malignancy in around 20% of cases.22 Around 80% of brain metastases occur in the cerebral hemispheres, 15% in the cerebellum, and 5% in the brain stem. 

Encephalopathy, peripheral neuropathy, cerebellar syndromes, autonomic neuropathy, and cranial nerve toxicity represent the range of neurological complications associated with cancer chemotherapy. Dose, route of administration, age of the patient, hepatic and renal function, prior and/or concomitant use of other neurotoxic drugs, and the concurrent use of cranial or CNS radiotherapy can each influence the incidence rate and severity of neurologic symptoms associated with selected chemotherapy drugs. 

Quant E, Plotkin S, Wen P. Neurologic complications of non-platinum cancer chemotherapy. In Basow DS, editor. Waltham, MA UpToDate 2011. http // www.uptodate.com/contents/neurologic-complications-of-non-platinum-cancer-chemotherapy source=search result search=non-platinum selectedTitle=l 150. 

Leptomeningeal metastasis (EM) occurs in 5% of patients with breast cancer. This complication can lead to neurological deterioration without early diagnosis and treatment. This is complicated by the fact that 25% of cerebrospinal fluid (CSF) samples produce false-negative results when examined cytologically. Dekker et al. have developed an MS-based method to investigate protein expression... 

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