Abstract

The fate of patients with leukemia has greatly improved in the past decades. Survival has been increased and the once stereotypic pattern of Cerebrospinal fluid (CSF) infiltration and diffuse infiltration of nerves and muscles has entirely changed. Peripheral nervous structures as cranial nerves, nerve roots, plexus and peripheral nerves can be affected in different types of leukemia, by different mechanisms and at different time points. Treatment side effects become more apparent, as the number of long term survivors increases. In some cases also isolated relapses of leukemia in the nervous system occurs and effects of stem cell transplantation on the nervous system became apparent. Diagnostically the cranial nerves, nerve roots, cauda equina, nerve plexus and the peripheral nerves have become more accessible to investigation due to improved imaging methods as ultrasound and MRI, thus facilitating the earlier diagnosis and treatment of nerve involvement.

Highlights

  • The peripheral nervous system is commonly classified into intraand extra cranial/medullary parts

  • It consist of cranial nerves, nerve roots, the cauda equina, nerve plexus, peripheral nerves, the area of the neuromuscular transmission and muscles

  • The spinal cord can be affected by epidural deposits, dural leukemia [2] and granulocytic sarcoma, or chloroma which can result in spinal compression

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Summary

Introduction

The peripheral nervous system is commonly classified into intraand extra cranial/medullary parts. It consist of cranial nerves, nerve roots, the cauda equina, nerve plexus, peripheral nerves, the area of the neuromuscular transmission and muscles. The cranial nerves and nerve roots as well as the cauda equina can be involved in neoplastic involvement of the CSF. Within the CSF space several types of nerve involvement occur: meningeal leukemia causes CN deficits and polytopic radicular symptoms. Peripheral nerve involvement in leukemia does not necessarily in involve the CSF [3]. Various mechanisms of neoplastic nerve damage as infiltration, compression by leukemic masses and hemorrhage into nerves occur and in addition toxicity of drug treatment, and rarely autoimmune and paraneoplastic cases [4]. Muscles can be diffusely infiltrated [13,14,15]

Materials and Methods
Discussion

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