Show Summary Details
Page of

Neurological problems in advanced cancer 

Neurological problems in advanced cancer
Chapter:
Neurological problems in advanced cancer
Author(s):

Max Watson

, Rachel Campbell

, Nandini Vallath

, Stephen Ward

, and Jo Wells

DOI:
10.1093/med/9780198745655.003.0013
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2016. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 22 August 2019

This chapter covers the common neurological symptoms encountered in patients with advanced malignancy such as seizures, local and central nerve damage, and paraneoplastic neurological syndromes. Non-convulsive status epilepticus (NCSE) is a possible cause of confusion or delirium in terminally ill patients. The clinical presentation varies from altered mental status to comatose patients, without visible convulsions. In comatose patients, unilateral tonic head and eye movement is often observed. Other symptoms include myoclonic contractions of the angle of the mouth, mild clonus of an extremity, or, rarely, epileptic nystagmus. EEG is the most important diagnostic tool to identify epileptiform activity. Treatment should be initiated following a stepwise model (e.g. phenytoin, sodium valproate, levetiracetam, together with benzodiazepines), avoid intubation, and transfer to the intensive care unit. Although mortality rates are high, in some patients NCSE can be reversed by treatment.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.