Neurological Facets of Hematological Malignancies: A Case Series

Abstract

Background: Central nerve involvement is a serious complication in hemopathies. Clinical presentations are heterogeneous; it can affect the central nervous system as well as the peripheral. The pathophysiological mechanisms are multiple. Aims: To illustrate the diversity of these neurological manifestations affecting both the central and peripheral nervous systems. We study the pathophysiological mechanisms and diagnostic strategies. We discuss the therapeutic alternatives and the prognostic value of neurological damage. Methods: To illustrate the clinical and etiological polymorphism, we report a series of clinical cases of seven patients followed for malignant hemopathies and who consulted for different neurological manifestations. Results: We have seven patients followed for malignant hemopathies: Acute lymphoblastic Leukemia (ALL), Acute myeloblastic Leukemia (AML), Myelodysplasic syndrome (MDS), Chronic myeloid Leukemia (CML). Patients consult for different neurological manifestations (optic neuritis, neuropathic pain, sensory and motor deficit, myopathic syndrome. The etiological assessment identified different causes and mechanisms: leukemic medullary infiltration (myelitis) and optic nerve (optic neuritis). Acute post infectious polyradiculoneuritis in a patient undergoing chemotherapy. The neurological manifestations related to drugs were painful peripheral neuropathy and myopathic syndrome secondary to cytarabine syndrome. The fatal outcome was associated with extensive infiltration and fulminant neurovascularitis induced by MDS. Conclusion: We discuss here through our series the different epidemiological, physiopathological, clinical, evolutionary and prognostic aspects of neurological complications of hematological malignancies.