Neurological problems in cancer

Abstract

Brain metastases are common, with a rising prevalence; enhanced magnetic resonance imaging (MRI) is the most sensitive test Bony spinal metastases can cause spinal cord compression. Initially, spinal pain is common, followed by bilateral pyramidal leg weakness. The site of pain or sensory level does not correlate well with the level of cord compression. Spine MRI is the investigation of choice Neoplastic meningitis is direct invasion of leptomeninges and/or cerebrospinal fluid (CSF) by cancer cells. Symptoms and signs vary: there should be high clinical suspicion in multifocal neuroaxis disease with 'lymphocytic meningitis' in patients not known to have cancer Paraneoplastic neurological disorders (PNDs) are rare but important as they usually occur before a diagnosis of cancer. The underlying cancer is almost always localised, therefore the chances of cure are highest. Paraneoplastic antibodies are found in serum and CSF in some PNDs associated with certain cancers.