Abstract
AetiopathegenesisTumour action can be due to direct damage to the nervous structures of the cerebral parenchyma or to the peripheral nerves or their respective casings, either due primary tumour growth or, most commonly (92%), due to cerebral metastasis. In more than 30% the origin will be a breast cancer, and around 10% will be of haematological, pulmonary or gynaecological origin. Indirect involvement due to vascular damage or inflammatory cytokines might precede tumour appearance (paraneoplastic syndrome) or be secondary to treatment (chemo- or radiotherapy-induced neurotoxicity). Clinical pictureOn the one hand, intracranial, medullar, lepatomeningeal (meningeal carcinomatosis) and neural (peripheral plexus and nerves) metastatic involvement are considered, and on the other, non-metastatic complications including alterations of consciousness level or delirium, neurotoxic effects of chemo- and radiotherapy and those deriving from diagnostic and surgical procedures, vascular disorders and infections, and sympathetic hyperactivity. DiagnosisImaging techniques with high-contrast capacity should include magnetic resonance imaging, electromyography and electroencephalography and nuclear medicine techniques. TreatmentTreatment of neuropathy symptoms and non-metastatic disorders is usually susceptible to improvement, at least in part. However this does not apply to the management of metastasis, which even today continues to have a poor prognosis in general.
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