The spectrum of neurological disease in patients with systemic cancer
To ascertain the range of neurological problems in patients with systemic cancer, we prospectively evaluated neurological sysmptoms, neurological diagnoses, and primary tumors in all patients with a history of systemic cancer examined by the Department of Neurology at the Memorial Sloan–Kettering Ca...
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Veröffentlicht in: | Annals of neurology 1992-03, Vol.31 (3), p.268-273 |
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description | To ascertain the range of neurological problems in patients with systemic cancer, we prospectively evaluated neurological sysmptoms, neurological diagnoses, and primary tumors in all patients with a history of systemic cancer examined by the Department of Neurology at the Memorial Sloan–Kettering Cancer Center, from Jul 1, 1990, to Dec 31, 1990. Of the 851 patients seen for neurological symptoms, less than half (45.2%) had metastatic involvement of the nervous system. The three most common symptoms were back pain (18.2%), altered mental status (17.1%), and headache (15.4%). The most common neurological diagnosis was brain metastasis (15.9%), followed by metabolic encephalopathy (10.2%), pain associated with bone metastases only (9.9%), and epidural extension or metastasis of tumor (8.4%). Of 133 patients with undiagnosed back or neck pain, 44 (33%) had epidural extension or metastases from tumor and 40 (30%) had pain associated with vertebral metastases only. In 15 (11%) the cause for the back pain was unrelated to metastatisc disease. Of 132 patients seen on initial consultation for altered mental status, metabolic encephalopathy was the major neurological diagnosis (80; 61%); 20 (15%) had intracranial metastases. Of 97 patients with undiagnosed headache, 59 (61%) had a nonstructural cause. Fifty‐three of these patients had either migraine, tension headache, or headache related to systemic illness (e.g., fever, sepsis). These results indicate that even in patients with systemic cancer, a group particularly prone to developing neurological disease that can be diagnosed radiologically, the role of clinicians remains important in helping distinguish noncancer‐related and nonmetastatisc neurological problems. |
doi_str_mv | 10.1002/ana.410310307 |
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Of the 851 patients seen for neurological symptoms, less than half (45.2%) had metastatic involvement of the nervous system. The three most common symptoms were back pain (18.2%), altered mental status (17.1%), and headache (15.4%). The most common neurological diagnosis was brain metastasis (15.9%), followed by metabolic encephalopathy (10.2%), pain associated with bone metastases only (9.9%), and epidural extension or metastasis of tumor (8.4%). Of 133 patients with undiagnosed back or neck pain, 44 (33%) had epidural extension or metastases from tumor and 40 (30%) had pain associated with vertebral metastases only. In 15 (11%) the cause for the back pain was unrelated to metastatisc disease. Of 132 patients seen on initial consultation for altered mental status, metabolic encephalopathy was the major neurological diagnosis (80; 61%); 20 (15%) had intracranial metastases. Of 97 patients with undiagnosed headache, 59 (61%) had a nonstructural cause. Fifty‐three of these patients had either migraine, tension headache, or headache related to systemic illness (e.g., fever, sepsis). These results indicate that even in patients with systemic cancer, a group particularly prone to developing neurological disease that can be diagnosed radiologically, the role of clinicians remains important in helping distinguish noncancer‐related and nonmetastatisc neurological problems.</description><identifier>ISSN: 0364-5134</identifier><identifier>EISSN: 1531-8249</identifier><identifier>DOI: 10.1002/ana.410310307</identifier><identifier>PMID: 1637135</identifier><identifier>CODEN: ANNED3</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adult ; Antineoplastic Agents - adverse effects ; Biological and medical sciences ; Cerebrovascular Disorders - complications ; Cerebrovascular Disorders - epidemiology ; Child ; Comorbidity ; Consciousness Disorders - epidemiology ; Consciousness Disorders - etiology ; Female ; Humans ; Incidence ; Male ; Medical sciences ; Mental Disorders - complications ; Mental Disorders - epidemiology ; Movement Disorders - epidemiology ; Movement Disorders - etiology ; Neoplasm Metastasis - physiopathology ; Neoplasms - classification ; Neoplasms - complications ; Neoplasms - epidemiology ; Nervous System Diseases - epidemiology ; Nervous System Diseases - etiology ; Neurology ; Osteoarthritis - complications ; Osteoarthritis - epidemiology ; Pain - epidemiology ; Pain - etiology ; Prospective Studies ; Radiotherapy - adverse effects ; Tumors of the nervous system. Phacomatoses</subject><ispartof>Annals of neurology, 1992-03, Vol.31 (3), p.268-273</ispartof><rights>Copyright © 1992 American Neurological Association</rights><rights>1992 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4037-f8f7bd7862f245ffdcc81d6501b3dae1f3bd4c3c43f8c3ffb4524e42f93483133</citedby><cites>FETCH-LOGICAL-c4037-f8f7bd7862f245ffdcc81d6501b3dae1f3bd4c3c43f8c3ffb4524e42f93483133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fana.410310307$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fana.410310307$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=5478363$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/1637135$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Clouston, Paul D.</creatorcontrib><creatorcontrib>DeAngelis, Lisa M.</creatorcontrib><creatorcontrib>Posner, Jerome B.</creatorcontrib><title>The spectrum of neurological disease in patients with systemic cancer</title><title>Annals of neurology</title><addtitle>Ann Neurol</addtitle><description>To ascertain the range of neurological problems in patients with systemic cancer, we prospectively evaluated neurological sysmptoms, neurological diagnoses, and primary tumors in all patients with a history of systemic cancer examined by the Department of Neurology at the Memorial Sloan–Kettering Cancer Center, from Jul 1, 1990, to Dec 31, 1990. Of the 851 patients seen for neurological symptoms, less than half (45.2%) had metastatic involvement of the nervous system. The three most common symptoms were back pain (18.2%), altered mental status (17.1%), and headache (15.4%). The most common neurological diagnosis was brain metastasis (15.9%), followed by metabolic encephalopathy (10.2%), pain associated with bone metastases only (9.9%), and epidural extension or metastasis of tumor (8.4%). Of 133 patients with undiagnosed back or neck pain, 44 (33%) had epidural extension or metastases from tumor and 40 (30%) had pain associated with vertebral metastases only. In 15 (11%) the cause for the back pain was unrelated to metastatisc disease. Of 132 patients seen on initial consultation for altered mental status, metabolic encephalopathy was the major neurological diagnosis (80; 61%); 20 (15%) had intracranial metastases. Of 97 patients with undiagnosed headache, 59 (61%) had a nonstructural cause. Fifty‐three of these patients had either migraine, tension headache, or headache related to systemic illness (e.g., fever, sepsis). These results indicate that even in patients with systemic cancer, a group particularly prone to developing neurological disease that can be diagnosed radiologically, the role of clinicians remains important in helping distinguish noncancer‐related and nonmetastatisc neurological problems.</description><subject>Adult</subject><subject>Antineoplastic Agents - adverse effects</subject><subject>Biological and medical sciences</subject><subject>Cerebrovascular Disorders - complications</subject><subject>Cerebrovascular Disorders - epidemiology</subject><subject>Child</subject><subject>Comorbidity</subject><subject>Consciousness Disorders - epidemiology</subject><subject>Consciousness Disorders - etiology</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental Disorders - complications</subject><subject>Mental Disorders - epidemiology</subject><subject>Movement Disorders - epidemiology</subject><subject>Movement Disorders - etiology</subject><subject>Neoplasm Metastasis - physiopathology</subject><subject>Neoplasms - classification</subject><subject>Neoplasms - complications</subject><subject>Neoplasms - epidemiology</subject><subject>Nervous System Diseases - epidemiology</subject><subject>Nervous System Diseases - etiology</subject><subject>Neurology</subject><subject>Osteoarthritis - complications</subject><subject>Osteoarthritis - epidemiology</subject><subject>Pain - epidemiology</subject><subject>Pain - etiology</subject><subject>Prospective Studies</subject><subject>Radiotherapy - adverse effects</subject><subject>Tumors of the nervous system. Phacomatoses</subject><issn>0364-5134</issn><issn>1531-8249</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1992</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kL1PwzAQxS0EKqUwMiJ5YE2xc46djBWUgqjKUsRoOY5NDfmo7FSl_z2pUhUmpJNuuN_dvfcQuqZkTAmJ71StxowS6IqIEzSkCdAojVl2ioYEOIsSCuwcXYTwSQjJOCUDNKAcBIVkiKbLlcFhbXTrNxVuLK7Nxjdl8-G0KnHhglHBYFfjtWqdqduAt65d4bALramcxlrV2vhLdGZVGczVoY_Q2-N0ef8UzV9nz_eTeaQZARHZ1Iq8ECmPbcwSawutU1rwhNAcCmWohbxgGjQDm2qwNmdJzAyLbQYsBQowQlF_V_smBG-sXHtXKb-TlMh9GrJLQx7T6Pibnl9v8soUv3Rvv5vfHuYqdH6t79y4cMQSJlLg-7eix7auNLv_f8rJYvJXwEGw6_L6Pm4q_yW5AJHI98VMpg9xFmcvXFL4AaVjhn0</recordid><startdate>199203</startdate><enddate>199203</enddate><creator>Clouston, Paul D.</creator><creator>DeAngelis, Lisa M.</creator><creator>Posner, Jerome B.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Willey-Liss</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>199203</creationdate><title>The spectrum of neurological disease in patients with systemic cancer</title><author>Clouston, Paul D. ; DeAngelis, Lisa M. ; Posner, Jerome B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4037-f8f7bd7862f245ffdcc81d6501b3dae1f3bd4c3c43f8c3ffb4524e42f93483133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1992</creationdate><topic>Adult</topic><topic>Antineoplastic Agents - adverse effects</topic><topic>Biological and medical sciences</topic><topic>Cerebrovascular Disorders - complications</topic><topic>Cerebrovascular Disorders - epidemiology</topic><topic>Child</topic><topic>Comorbidity</topic><topic>Consciousness Disorders - epidemiology</topic><topic>Consciousness Disorders - etiology</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental Disorders - complications</topic><topic>Mental Disorders - epidemiology</topic><topic>Movement Disorders - epidemiology</topic><topic>Movement Disorders - etiology</topic><topic>Neoplasm Metastasis - physiopathology</topic><topic>Neoplasms - classification</topic><topic>Neoplasms - complications</topic><topic>Neoplasms - epidemiology</topic><topic>Nervous System Diseases - epidemiology</topic><topic>Nervous System Diseases - etiology</topic><topic>Neurology</topic><topic>Osteoarthritis - complications</topic><topic>Osteoarthritis - epidemiology</topic><topic>Pain - epidemiology</topic><topic>Pain - etiology</topic><topic>Prospective Studies</topic><topic>Radiotherapy - adverse effects</topic><topic>Tumors of the nervous system. Phacomatoses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Clouston, Paul D.</creatorcontrib><creatorcontrib>DeAngelis, Lisa M.</creatorcontrib><creatorcontrib>Posner, Jerome B.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Annals of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Clouston, Paul D.</au><au>DeAngelis, Lisa M.</au><au>Posner, Jerome B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The spectrum of neurological disease in patients with systemic cancer</atitle><jtitle>Annals of neurology</jtitle><addtitle>Ann Neurol</addtitle><date>1992-03</date><risdate>1992</risdate><volume>31</volume><issue>3</issue><spage>268</spage><epage>273</epage><pages>268-273</pages><issn>0364-5134</issn><eissn>1531-8249</eissn><coden>ANNED3</coden><abstract>To ascertain the range of neurological problems in patients with systemic cancer, we prospectively evaluated neurological sysmptoms, neurological diagnoses, and primary tumors in all patients with a history of systemic cancer examined by the Department of Neurology at the Memorial Sloan–Kettering Cancer Center, from Jul 1, 1990, to Dec 31, 1990. Of the 851 patients seen for neurological symptoms, less than half (45.2%) had metastatic involvement of the nervous system. The three most common symptoms were back pain (18.2%), altered mental status (17.1%), and headache (15.4%). The most common neurological diagnosis was brain metastasis (15.9%), followed by metabolic encephalopathy (10.2%), pain associated with bone metastases only (9.9%), and epidural extension or metastasis of tumor (8.4%). Of 133 patients with undiagnosed back or neck pain, 44 (33%) had epidural extension or metastases from tumor and 40 (30%) had pain associated with vertebral metastases only. In 15 (11%) the cause for the back pain was unrelated to metastatisc disease. Of 132 patients seen on initial consultation for altered mental status, metabolic encephalopathy was the major neurological diagnosis (80; 61%); 20 (15%) had intracranial metastases. Of 97 patients with undiagnosed headache, 59 (61%) had a nonstructural cause. Fifty‐three of these patients had either migraine, tension headache, or headache related to systemic illness (e.g., fever, sepsis). These results indicate that even in patients with systemic cancer, a group particularly prone to developing neurological disease that can be diagnosed radiologically, the role of clinicians remains important in helping distinguish noncancer‐related and nonmetastatisc neurological problems.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>1637135</pmid><doi>10.1002/ana.410310307</doi><tpages>6</tpages></addata></record> |
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subjects | Adult Antineoplastic Agents - adverse effects Biological and medical sciences Cerebrovascular Disorders - complications Cerebrovascular Disorders - epidemiology Child Comorbidity Consciousness Disorders - epidemiology Consciousness Disorders - etiology Female Humans Incidence Male Medical sciences Mental Disorders - complications Mental Disorders - epidemiology Movement Disorders - epidemiology Movement Disorders - etiology Neoplasm Metastasis - physiopathology Neoplasms - classification Neoplasms - complications Neoplasms - epidemiology Nervous System Diseases - epidemiology Nervous System Diseases - etiology Neurology Osteoarthritis - complications Osteoarthritis - epidemiology Pain - epidemiology Pain - etiology Prospective Studies Radiotherapy - adverse effects Tumors of the nervous system. Phacomatoses |
title | The spectrum of neurological disease in patients with systemic cancer |
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