Neurologic Complications of Cancer

Book excerpt: Patients with cancer can suffer from a bewildering variety of neurologic signs and symptoms. The neurologic symptoms are often more disabling than the primary cancer. Symptoms including confusion, seizures, pain and paralysis may be a result of either metastases to the nervous system or one of several nonmetastatic complications of cancer. The physician who promptly recognizes neurologic symptoms occurring in a patient with cancer and makes an early diagnosis may prevent the symptoms from becoming permanently disabling or sometimes lethal. This monograph, an update of the first edition published in 1995, is divided into 3 sections. The first classifies the wide variety of disorders that can cause neurologic symptoms the patient with cancer, discusses the pathophysiology of nervous system metastases, the pathophysiology and treatment of brain edema and the approach to supportive care of common neurologic symptoms such as seizures, pain, and side effects of commonly used supportive care agents. The second section is devoted to nervous system metastases, addressing in turn, brain, spinal cord, meningeal and cranial and peripheral nerve metastases, describing clinical symptoms, approach to diagnosis and current treatment. The third section addresses several nonmetastatic complications of cancer and includes sections on vascular disease, infections, metabolic and nutritional disorders, side chemotherapy, radiation and other diagnostic and therapeutic procedures. The final chapter addresses paraneoplastic syndromes.The book is intended for practicing oncologists, neurologists, neurosurgeons and radiation oncologists as well as internists who treated patients with cancer. Our attempt was to write a book that would assist oncologists in understanding neurologic problems and neurologists in understanding oncologic problems. The book is also intended for physicians training to specialize in any of the above areas. It includes a practical approach to the diagnosis and management of patients with neurologic disease who are with known to have cancer or in whom cancer is suspected.