[Neurologic consultation in cancer patients]

Abstract

Objective: To inventory neurological complications in patients with cancer.

Design: Descriptive study.

Setting: University Hospital Vrije Universiteit, Amsterdam.

Method: Data were collected from 718 neurological consultations with 610 admitted oncological patients from 1990 to 1992.

Results: In 203 cases backache, sometimes radiating to the leg, prompted the request for neurological consultation. In 142 cases a metastasis in the vertebrae could be detected; in 64 cases there were signs and/or symptoms of compression. Cerebral metastasis occurred in 133 patients in which eventuality neurological dysfunctions were the main initial manifestations. In all, 32 cases of leptomeningeal metastasis were diagnosed, mostly associated with carcinoma of the breast or haematological system. In 30 cases there was growth of a primary tumour or metastasis into a plexus or peripheral nerve. Non-metastatic complications consisted of paraneoplastic, iatrogenic and other (mostly metabolic or toxic encephalopathy) causes. A paraneoplastic complication was seen in only 6 cases. Iatrogenic complications were most frequently caused by cytotherapy.

Conclusion: Numerous neurological complications can occur in patients with cancer. Timely treatment of metastatic complications can prevent serious disablement in a terminal stadium of the disease.