Neoplastic meningitis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
When evaluating a patient for neoplastic meningitis, you should take a detailed history of the presenting symptom (onset, duration, and progression), other associated symptoms, and a thorough family and past medical history review. Other specific areas of focus when obtaining the history include review of common associated conditions such as intracerebral metastases and the distant primary tumors. Neoplastic meningitis should be suspected if there are simultaneous occurrence of symptoms or signs in more than one area of the neuraxis.[1] Symptoms of neoplastic meningitis include headaches, confusion, memory loss, seizures, double vision, hearing loss, paresthesia and pain in the neck and back, and limb weakness.[2]
History
When evaluating a patient for neoplastic meningitis, you should take a detailed history of the presenting symptom (onset, duration, and progression), other associated symptoms, and a thorough family and past medical history review. Other specific areas of focus when obtaining the history include review of common associated conditions such as intracerebral metastases and the distant primary tumors. Neoplastic meningitis should be suspected if there are simultaneous occurrence of symptoms or signs in more than one area of the neuraxis.[3]
Symptoms
Symptoms of neoplastic meningitis are pleomorphic due to involvement of three domains of the neurological function, which include:[2]
- Cerebral hemisphere (15%)
- Cranial nerves (35%)
- Spinal cord and roots (60%)
Symptoms due to cerebral hemisphere dysfunction
Symptoms due to cranial nerve dysfunction
- Cranial nerve III
- Cranial nerve IV
- Cranial nerve VI
- Cranial nerve V
- Facial hypesthesia or anesthesia
- Weakness of clenching and side-to-side movement of the jaw
- Cranial nerve VIII
Symptoms due to spinal cord and roots dysfunction
- Limb weakness (lower extremities > upper extremities)
- Sensory loss and pain in the neck and back
- Neck rigidity
- Urinary retention
- Urinary incontinence
- Diarrhea
- Constipation
- Rectal prolapse
Symptoms due to elevated intracranial pressure caused by hydrocephalus
References
- ↑ "Infiltration of the Leptomeninges by Systemic Cancer-A Clinical and Pathologic Study". doi:10.1001/archneur.1974.00490320010002. Check
|doi=value (help). - ↑ 2.0 2.1 Chamberlain, M. C. (2008). "Neoplastic Meningitis". The Oncologist. 13 (9): 967–977. doi:10.1634/theoncologist.2008-0138. ISSN 1083-7159.
- ↑ "Infiltration of the Leptomeninges by Systemic Cancer-A Clinical and Pathologic Study". doi:10.1001/archneur.1974.00490320010002. Check
|doi=value (help).