Neoplastic meningitis history and symptoms

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]

Symptoms due to cerebral hemisphere dysfunction

Symptoms due to cranial nerve dysfunction

Cranial nerve III
- Drooping of the eyelid
Cranial nerve IV
- Double vision
Cranial nerve VI
- Double vision
Cranial nerve V
- Facial hypesthesia or anesthesia
- Weakness of clenching and side-to-side movement of the jaw
Cranial nerve VIII
- Hearing loss
- Tinnitus

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).

Template:WikiDoc Sources

[1] “Infiltration of the Leptomeninges by Systemic Cancer-A Clinical and Pathologic Study”. doi:10.1001/archneur.1974.00490320010002. Check |doi= value (help).

[Chamberlain2008-2] 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.

[3] “Infiltration of the Leptomeninges by Systemic Cancer-A Clinical and Pathologic Study”. doi:10.1001/archneur.1974.00490320010002. Check |doi= value (help).

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