Neuro-Oncology Emergencies Induced by Chemotherapy

Abstract

The central nervous system (CNS) and peripheral nervous system (PNS) are the frequent site of toxicity of chemotherapeutic agents [1]. The toxicity could manifest itself in a myriad of ways. This toxicity can manifest in many ways, including peripheral neuropathy, encephalopathy, seizures, visual loss, etc. For many drugs, the toxicity is related to route of administration and cumulative dose, and can vary from brief, transient episodes to more severe, chronic sequelae. Many of their adverse effects are unpredictable and irreversible, and thus may lead to serious long-term sequelae [2, 3]. With increasing use of dose-intense or myeloablative chemotherapy, neurotoxicity is becoming the dose-limiting factor in many situations. Whereas systemically administered drugs chiefly cause encephalopathy and seizures, intrathecally administered drugs may cause aseptic meningitis and spinal cord toxicity. Both oncologists and neurologists should be aware of these toxicities, their clinical presentation, prevention and treatment, if any. The following sections discuss some of the well-described effects of commonly used agents. Table 10.1 highlights the various sites of drug toxicity and the common drugs associated with the same.