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Section 6 - Nervous System

from Part 3 - Systems Based Overview of Cancer Complications

Published online by Cambridge University Press:  10 August 2023

Monica Kathleen Wattana
Monica Kathleen Wattana
Affiliation:
University of Texas, MD Anderson Cancer Center
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Summary

Overview of neurologic complications such as delirium, depression, elevated intracranial pressure, hemorrhage, leptomenigneal disease, seizure management, and spinal cord issues in cancer patients

Keywords

deliriumcord compressioncauda equinaseizuredepressionaltered mental status
Type
Chapter
Information
Pocket Guide to Oncologic Emergencies , pp. 211 - 258
Publisher: Cambridge University Press
Print publication year: 2023

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References

References

Damek, DM. Cerebral edema, altered mental status, seizures, acute stroke, leptomeningeal metastases, and paraneoplastic syndrome. Emergency Medical Clinics of North America. 2009;27(2):209‒229.CrossRefGoogle ScholarPubMed
Nolan, C, DeAngelis, LM. The confused oncologic patient: A rational clinical approach. Current Opinion in Neurology. 2016;29(6):789–796. Doi: 10.1097/WCO.0000000000000392.CrossRefGoogle Scholar
Doriath, V, Paesmans, M, Catteau, G, Hildebrand, J. Acute confusion in patients with systemic cancer. Journal of Neuro-Oncology. 2007 Jul;83(3):285–289. Doi: 10.1007/s11060-006-9319-6. Epub 2007 Jan 17.CrossRefGoogle ScholarPubMed
Yaka, E, Kaya, S, Pekdemir, M, Yilmaz, S, Uygun, K, Kama, A. Altered mental status in emergency department patients with cancer. Hong Kong Journal of Emergency Medicine. 2014;21(1):10–15.CrossRefGoogle Scholar

References

Bramati, P, Bruera, E. Delirium in palliative care. Cancers. 2021;13(23):5893. Doi: 10.3390/cancers13235893.CrossRefGoogle ScholarPubMed
Bush, SH, Lawlor, PG, Ryan, K, Centeno, C, Lucchesi, M, Kanji, S, Siddiqi, N, Morandi, A, Davis, DHJ, Laurent, M, Schofield, N, Barallat, E, Ripamonti, CI; ESMO Guidelines Committee. Delirium in adult cancer patients: ESMO clinical practice guidelines. Annals of Oncology. 2018 Oct 1; 29(Suppl 4):iv143‒iv165. Doi: 10.1093/annonc/mdy147. PMID: 29992308.CrossRefGoogle ScholarPubMed
De la Cruz, M. Delirium and palliative sedation. In The MD Anderson Supportive and Palliative Care Handbook, edited by Dalal, Shalini and Bruera, Eduardo (6th ed.) 2018. Houston: UT Health Printing Services.Google Scholar
El Majzoub, I, Abunafeesa, H, Cheaito, R, Cheaito, MA, Elsayem, AF. Management of altered mental status and delirium in cancer patients. Annals of Palliative Medicine. 2019 Nov;8(5):728–739. Doi: 10.21037/apm.2019.09.14. Epub 2019 Oct 23. PMID: 31735040.CrossRefGoogle ScholarPubMed
Han, JH, Wilson, A, Vasilevskis, EE, Shintani, A, Schnelle, JF, Dittus, RS, Graves, AJ, Storrow, AB, Shuster, J, Ely, EW. Diagnosing delirium in older emergency department patients: Validity and reliability of the delirium triage screen and the brief confusion assessment method. Annals of Emergency Medicine. 2013; 62:457–465.CrossRefGoogle ScholarPubMed
Lee, S, Gottlieb, M, Mulhausen, P, Wilbur, J, Reisinger, HS, Han, JH, Carnahan, R. Recognition, prevention, and treatment of delirium in emergency department: An evidence-based narrative review. The American Journal of Emergency Medicine. 2020 Feb;38(2):349–357. Doi: 10.1016/j.ajem.2019.158454. Epub 2019 Oct 8. PMID: 31759779.CrossRefGoogle ScholarPubMed

References

Barton, MK. Drug interactions in cancer patients receiving antidepressants are common, researchers report. CA: A Cancer Journal for Clinicians. 2011 Sep‒Oct;61(5):283–284. Doi: 10.3322/caac.20127. Epub 2011 Aug 8. PMID: 25930199.Google ScholarPubMed
Grassi, L, Nanni, MG, Rodin, G, Li, M, Caruso, R. The use of antidepressants in oncology: A review and practical tips for oncologists. Annals of Oncology. 2018 Jan 1; 29(1):101–111. Doi: 10.1093/annonc/mdx526. PMID: 29272358.CrossRefGoogle ScholarPubMed
Hoyer, D, David, E. Screening for depression in emergency department patients. Journal of Emergency Medicine. 2012 Nov;43(5):786–789. Doi: 10.1016/j.jemermed.2008.05.004. Epub 2008 Nov 20. PMID: 19022607.CrossRefGoogle ScholarPubMed
Mausbach, BT, Decastro, G, Schwab, RB, Tiamson-Kassab, M, Irwin, SA. Healthcare use and costs in adult cancer patients with anxiety and depression. Depress Anxiety. 2020 Sep;37(9):908–915. Doi: 10.1002/da.23059. Epub 2020 Jun 2. PMID: 32485033; PMCID: PMC7484454.CrossRefGoogle ScholarPubMed
Reyes, CC, Anderson, KO, Gonzalez, CE, Ochs, HC, Wattana, M, Acharya, G, Todd, KH. Depression and survival outcomes after emergency department cancer pain visits. BMJ Supportive and Palliative Care. 2019 Dec;9(4):e36. Doi: 10.1136/bmjspcare-2018-001533. Epub 2018 Aug 31. PMID: 30171043.Google ScholarPubMed
Smith, HR. Depression in cancer patients: Pathogenesis, implications and treatment (Review). Oncology Letters. 2015 Apr;9(4):1509–1514. Doi: 10.3892/ol.2015.2944. Epub 2015 Feb 9. PMID: 25788991; PMCID: PMC4356432.CrossRefGoogle ScholarPubMed

References

Esquenazi, Y, Lo, VP, Lee, K. Critical care management of cerebral edema in brain tumors. Journal of Intensive Care Medicine. 2017 Jan;32(1):15–24. Doi: 10.1177/0885066615619618. Epub 2015 Dec 8. PMID: 26647408.CrossRefGoogle ScholarPubMed
Lin, AL, Avila, EK. Neurologic emergencies in the patients with cancer. Journal of Intensive Care Medicine. 2017 Feb;32(2):99–115. Doi: 10.1177/0885066615619582. Epub 2016 Jul 9. PMID: 26704760; PMCID: PMC5473518.CrossRefGoogle ScholarPubMed
Pandhi, A, Krishnan, R, Goyal, N, Malkoff, M. Increased intracranial pressure in critically ill cancer patients, in J Nates and K Price (eds). Oncologic Critical Care (2018):1‒13. Doi: 10.1007/978-3-319-74698-2_36-1.CrossRefGoogle Scholar
Pinto, VL, Tadi, P, Adeyinka, A. Increased intracranial pressure. [Updated May 2, 2022]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan. Available at: www.ncbi.nlm.nih.gov/books/NBK482119/Google Scholar

References

Caceres, JA, Goldstein, JN. Intracranial hemorrhage. Emergency Medicine Clinics of North America. 2012 Aug;30(3):771–794. Doi: 10.1016/j.emc.2012.06.003. PMID: 22974648; PMCID: PMC3443867.CrossRefGoogle ScholarPubMed
Marcolini, E, Stretz, C, DeWitt, KM. Intracranial hemorrhage and intracranial hypertension. Emergency Medicine Clinics of North America. 2019 Aug;37(3):529–544. Doi: 10.1016/j.emc.2019.04.001. PMID: 31262419.CrossRefGoogle ScholarPubMed
Navi, BB, Reichman, JS, Berlin, D, Reiner, AS, Panageas, KS, Segal, AZ, DeAngelis, LM. Intracerebral and subarachnoid hemorrhage in patients with cancer. Neurology. 2010 Feb 9;74(6):494–501. Doi: 10.1212/WNL.0b013e3181cef837. PMID: 20142616; PMCID: PMC2830918.CrossRefGoogle ScholarPubMed
Velander, AJ, DeAngelis, LM, Navi, BB. Intracranial hemorrhage in patients with cancer. Current Atherosclerosis Reports. 2012 Aug;14(4):373–381. Doi: 10.1007/s11883-012-0250-3. PMID: 22528522.CrossRefGoogle ScholarPubMed

References

Grossman, SA, Krabak, MJ. Leptomeningeal carcinomatosis. Cancer Treatment Reviews. 1999 Apr;25(2):103–119. Doi: 10.1053/ctrv.1999.0119. PMID: 10395835.CrossRefGoogle ScholarPubMed
Oki, E, Makiyama, A, Miyamoto, Y, Kotaka, M, Kawanaka, H, Miwa, K, Kabashima, A, Noguchi, T, Yuge, K, Kashiwada, T, Ando, K, Shimokawa, M, Saeki, H, Akagi, Y, Baba, H, Maehara, Y, Mori, M. Trifluridine/tipiracil plus bevacizumab as a first-line treatment for elderly patients with metastatic colorectal cancer (KSCC1602): A multicenter phase II trial. Cancer Medicine. 2021 Jan;10(2):454–461. Doi: 10.1002/cam4.3618. Epub 2020 Nov 29. Erratum in: Cancer Medicine. 2021 Jun; 10(11):3836. PMID: 33249761; PMCID: PMC7877360.CrossRefGoogle ScholarPubMed
Wang, N, Bertalan, MS, Brastianos, PK. Leptomeningeal metastasis from systemic cancer: Review and update on management. Cancer. 2018 Jan 1;124(1):21–35. Doi: 10.1002/cncr.30911. Epub 2017 Nov 22. PMID: 29165794.CrossRefGoogle ScholarPubMed

References

Kamoto, Y, Sadato, N, Yonekura, Y, Tsuchida, T, Uematsu, H, Waki, A, Uchida, K, Baba, H, Imura, S, Konishi, J. Visualization of the cervical spinal cord with FDG and high-resolution PET. Journal of Computer Assisted Tomography. 1998;22:487–491.CrossRefGoogle ScholarPubMed
Lawton, AJ, Lee, KA, Cheville, AL, Ferrone, ML, Rades, D, Balboni, TA, Abrahm, JL. Assessment and management of patients with metastatic spinal cord compression: A multidisciplinary review. Journal of Clinical Oncology. 2019 Jan 1;37(1):61–71. Doi: 10.1200/JCO.2018.78.1211. Epub 2018 Nov 5. PMID: 30395488.CrossRefGoogle ScholarPubMed
Rajer, M, Kovač, V. Malignant spinal cord compression. Radiology and Oncology 2008;42(1):23–31. Doi: 10.2478/v10019-007-0035-4.CrossRefGoogle Scholar

References

Castaneda, D, Miret, R, Rajagopalan, R, Castillo, M, Gonzalez, A, Castro, F. Chronic intestinal pseudo-obstruction due to incidentally found thymoma, ACG Case Reports Journal. 2021 May;8(5):e00608. Doi: 10.14309/crj.0000000000000608CrossRefGoogle ScholarPubMed
Graus, F, Dalmau, J. Paraneoplastic neurological syndromes. Current Opinion in Neurology. 2012 Dec;25(6):795–801. Doi: 10.1097/WCO.0b013e328359da15. PMID: 23041955; PMCID: PMC3705179.CrossRefGoogle ScholarPubMed
Höftberger, R, Rosenfeld, MR, Dalmau, J. Update on neurological paraneoplastic syndromes. Current Opinion in Oncology. 2015 Nov;27(6):489–495. Doi: 10.1097/CCO.0000000000000222. PMID: 26335665; PMCID: PMC4640358.CrossRefGoogle ScholarPubMed
Klaas, JP, Ahlskog, JE, Pittock, SJ, Matsumoto, JY, Aksamit, AJ, Bartleson, JD, Kumar, R, McEvoy, KF, McKeon, A. Adult-onset opsoclonus-myoclonus syndrome. Archives of Neurology. 2012;69(12):1598–1607. Doi: 10.1001/archneurol.2012.1173.CrossRefGoogle ScholarPubMed
Luu, X, Leonard, S, Joseph, KA. Dermatomyositis presenting as a paraneoplastic syndrome with resolution of symptoms following surgical management of underlying breast malignancy. Journal of Surgical Case Reports. 2015;(7):rjv075. Doi: 10.1093/jscr/rjv075.CrossRefGoogle Scholar

References

Costa, J, Haddad, FG, Costa, G, Harb, A, Eid, R, Kourie, HR, Helou, JE. Seizures in cancer patients: A vast spectrum of etiologies. Future Neurology. 2019;14:FNL30.CrossRefGoogle Scholar
Grönheit, W, Popkirov, S, Wehner, T, Schlegel, U, Wellmer, J. Practical management of epileptic seizures and status epilepticus in adult palliative care patients. Frontiers in Neurology. 2018;9. Doi: 10.3389/fneur.2018.00595.CrossRefGoogle ScholarPubMed
Ho, K, Lawn, N, Bynevelt, M, Lee, J, Dunne, J. Neuroimaging of first-ever seizure: Contribution of MRI if CT is normal. Neurology: Clinical Practice. 2013;3:398–403.Google Scholar
Lin, AL, Avila, EK. Neurologic emergencies in the patients with cancer. Journal of Intensive Care Medicine. 2017;32:99–115. Doi: 10.1177/0885066615619582.CrossRefGoogle ScholarPubMed
Mamon, HJ, Wen, PY, Burns, AC, Loeffler, JS. Allergic skin reactions to anticonvulsant medications in patients receiving cranial radiation therapy. Epilepsia. 1999 Mar;40(3):341–344.CrossRefGoogle ScholarPubMed
Nowacki, TA, Jirsch, JD. Evaluation of the first seizure patient: Key points in the history and physical examination. Seizure. 2017 Jul;49:54–63.CrossRefGoogle ScholarPubMed
Sarmast, ST, Abdullahi, AM, Jahan, N. (2020). Current classification of seizures and epilepsies: Scope, limitations and recommendations for future action. Cureus. 2020; 12(9):e10549. Doi: 10.7759/cureus.10549.Google ScholarPubMed
Singh, G, Rees, JH, Sander, JW. Seizures and epilepsy in oncological practice: Causes, course, mechanisms and treatment. Journal of Neurology, Neurosurgery and Psychiatry. 2007;78(4):342–349. Doi: 10.1136/jnnp.2006.106211.CrossRefGoogle ScholarPubMed
Tradounsky, G. Seizures in palliative care. Canadian Family Physician. 2013;59(9):951‒e405.Google ScholarPubMed

References

Bang, OY, Chung, JW, Lee, MJ, Seo, WK, Kim, GM, Ahn, MJ; OASIS-Cancer Study Investigators. Cancer-related stroke: An emerging subtype of ischemic stroke with unique pathomechanisms. Journal of Stroke. 2020 Jan;22(1):1–10. Doi: 10.5853/jos.2019.02278. Epub 2020 Jan 31. PMID: 32027788; PMCID: PMC7005348.CrossRefGoogle ScholarPubMed
Dardiotis, E, Aloizou, AM, Markoula, S, Siokas, V, Tsarouhas, K, Tzanakakis, G, Libra, M, Kyritsis, AP, Brotis, AG, Aschner, M, Gozes, I, Bogdanos, DP, Spandidos, DA, Mitsias, PD, Tsatsakis, A. Cancer-associated stroke: Pathophysiology, detection and management (Review). International Journal of Oncology. 2019 Mar;54(3):779–796. Doi: 10.3892/ijo.2019.4669. Epub 2019 Jan 2. PMID: 30628661; PMCID: PMC6365034.Google ScholarPubMed
Lin, AL, Avila, EK. Neurologic emergencies in the patients with cancer. Journal of Intensive Care Medicine. 2017 Feb;32(2):99–115. Doi: 10.1177/0885066615619582. Epub 2016 Jul 9. PMID: 26704760; PMCID: PMC5473518.CrossRefGoogle ScholarPubMed
Navi, BB, Iadecola, C. Ischemic stroke in cancer patients: A review of an underappreciated pathology. Annals of Neurology. 2018 May;83(5):873–883. Doi: 10.1002/ana.25227. Epub 2018 Apr 30. PMID: 29633334; PMCID: PMC6021225.CrossRefGoogle ScholarPubMed
Rogers, LR. Management of stroke in cancer. Current Oncology Reports. 2008 Jan;10(1):72–77. Doi: 10.1007/s11912-008-0011-1. PMID: 18366963.CrossRefGoogle ScholarPubMed
Schwarzbach, CJ, Fatar, M, Eisele, P, Ebert, AD, Hennerici, MG, Szabo, K. DWI lesion patterns in cancer-related stroke: Specifying the phenotype. Cerebrovascular Diseases Extra. 2015;5(3):139–145. Published Oct 30, 2015. Doi:10.1159/000439549.CrossRefGoogle ScholarPubMed
Seltzer, J, Neill, L. Emergency guide to stroke neuroimaging. [NUEM Blog. Expert Commentary by B Jahromi]. Jan 6, 2020, Available at: www.nuemblog.com/blog/2018/4/20/stroke-neuroimagingGoogle Scholar
Sun, B, Fan, S, Li, Z, Guo, W, Liu, L, Zhou, Y, Ji, L, Zhang, L, Huang, X. Clinical and neuroimaging features of acute ischemic stroke in cancer patients. European Journal of Neurology. 2016;75(5‒6):292–9. Doi: 10.1159/000447126. Epub 2016 Jun 15. PMID: 27300135.Google ScholarPubMed
Zaorsky, NG, Zhang, Y, Tchelebi, LT, Mackley, HB, Chinchilli, VM, Zacharia, BE. Stroke among cancer patients. Nature Communications. 2019;10:5172. Doi: 10.1038/s41467-019-13120-6.CrossRefGoogle ScholarPubMed

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