Skip to main content

Advertisement

SpringerLink
Log in

Neurological complications of pediatric cancer

  • Published:
Cancer and Metastasis Reviews Aims and scope Submit manuscript

A Correction to this article was published on 12 February 2020

This article has been updated

Abstract

Both the onset of various malignancies as well as the treatment of cancer can lead to neurologic symptoms which can be difficult to diagnose. In this review, we highlight the varied ways in which neurologic sequelae of cancer and its treatment manifest in children. Initial neurologic presentation may be secondary to mass effect or to immune-mediated paraneoplastic syndromes. Treatment effects on the nervous system may arise from surgery, chemotherapy, radiation, or bone marrow transplantation. In addition, the rapidly expanding field of immunotherapies for cancer has generated numerous new approaches to eradicating cancer including monoclonal antibodies, checkpoint inhibitors, and chimeric antigen receptor T cells (CAR-T cells), which have neurologic side effects mediated by immune responses that are also being recognized. Here we review common consult questions to the neurologist and our general approach to these scenarios including altered mental status, headaches, seizures, and sensorimotor complaints, considering the multifactorial nature of each.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Change history

  • 12 February 2020

    The authors have noticed a typographical error in the published article.

References

  1. Dobrovoljac, M., Hengartner, H., Boltshauser, E., & Grotzer, M. (2002). Delay in the diagnosis of paediatric brain tumours. Eur J Pediatr, 161(12), 663–667. https://doi.org/10.1007/s00431-002-1088-4.

    Article  PubMed  Google Scholar 

  2. Reulecke, B. C., Erker, C. G., Fiedler, B. J., Niederstadt, T.-U., & Kurlemann, G. (2008). Brain tumors in children: Initial symptoms and their influence on the time span between symptom onset and diagnosis. J Child Neurol, 23(2), 178–183. https://doi.org/10.1177/0883073807308692.

    Article  PubMed  Google Scholar 

  3. Ullrich, N. J. (2009). Neurologic sequelae of brain tumors in children. J Child Neurol, 24(11), 1446–1454. https://doi.org/10.1177/0883073809342491.

    Article  PubMed  Google Scholar 

  4. Wells, E. M., & Packer, R. J. (2015). Pediatric brain tumors. CONTINUUM: Lifelong Learning in Neurology, 21(2), 373–396. https://doi.org/10.1212/01.CON.0000464176.96311.d1.

    Article  PubMed  Google Scholar 

  5. Malbari, F., Gershon, T. R., Garvin, J. H., Allen, J. C., Khakoo, Y., Levy, A. S., & Dunkel, I. J. (2016). Psychiatric manifestations as initial presentation for pediatric CNS germ cell tumors, a case series. Childs Nerv Syst, 32(8), 1359–1362. https://doi.org/10.1007/s00381-016-3145-8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Taylor M, Couto-Silva, A-C, Adan L, Trivin C, Sainte-Rose C, Zerah M, … Brauner R (2012). Hypothalamic-pituitary lesions in pediatric patients: endocrine symptoms often precede neuro-ophthalmic presenting symptoms. J Pediatr, 161(5), 855–63. doi:https://doi.org/10.1016/j.jpeds.2012.05.014.

  7. Pretell-Mazzini, J., Chikwava, K. R., & Dormans, J. P. (2012). Low back pain in a child associated with acute onset cauda equina syndrome: a rare presentation of an aggressive vertebral hemangioma: a case report. J Pediatr Orthop, 32(3), 271–276. https://doi.org/10.1097/BPO.0b013e318247195a.

    Article  PubMed  Google Scholar 

  8. Mora, J., & Wollner, N. (1999). Primary epidural non-Hodgkin lymphoma: spinal cord compression syndrome as the initial form of presentation in childhood non-Hodgkin lymphoma. Med Pediatr Oncol, 32(2), 102–105. https://doi.org/10.1002/(SICI)1096-911X(199902)32:2<102::AID-MPO6>3.0.CO;2-Y.

    Article  CAS  PubMed  Google Scholar 

  9. Da Silva, A. N., Lopes, M. B., & Schiff, D. (2006). Rare pathological variants and presentations of primary central nervous system lymphomas. Neurosurg Focus, 21(5), E1–E7. https://doi.org/10.3171/foc.2006.21.5.8.

    Article  Google Scholar 

  10. Wilson, R. E., Oleszek, J. L., & Clayton, G. H. (2007). Pediatric spinal cord tumors and masses. J Spinal Cord Med, 30(sup1), S15–S20. https://doi.org/10.1080/10790268.2007.11753963.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ma, G. M., Chow, J. S., & Taylor, G. A. (2019). Review of paraneoplastic syndromes in children. Pediatr Radiol, 49(4), 534–550. https://doi.org/10.1007/s00247-019-04371-y.

    Article  PubMed  Google Scholar 

  12. Nikolic, D. M., Nikolic, A. V., Lavrnic, D. V., Medjo, B. P., & Ivanovski, P. I. (2012). Childhood-onset myasthenia gravis with thymoma. Pediatr Neurol, 46(5), 329–331. https://doi.org/10.1016/j.pediatrneurol.2012.02.025.

    Article  PubMed  Google Scholar 

  13. Wells, E. M., & Dalmau, J. (2011). Paraneoplastic neurologic disorders in children. Curr Neurol Neuroscie Rep, 11(2), 187–194. https://doi.org/10.1007/s11910-010-0169-4.

    Article  Google Scholar 

  14. Dalmau, J., & Rosenfeld, M. R. (2008). Paraneoplastic syndromes of the CNS. Lancet Neurol, 7(4), 327–340. https://doi.org/10.1016/S1474-4422(08)70060-7.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Graus, F., Delattre, J. Y., Antoine, J. C., Dalmau, J., Giometto, B., Grisold, W., Honnorat, J., Smitt, P. S., Vedeler Ch, Verschuuren, J. J., Vincent, A., & Voltz, R. (2004). Recommended diagnostic criteria for paraneoplastic neurological syndromes. J Neurol Neurosurg Psychiatry, 75(8), 1135–1140. https://doi.org/10.1136/jnnp.2003.034447.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Pranzatelli, M. R., Tate, E. D., Swan, J. A., Travelstead, A. L., Colliver, J. A., Verhulst, S. J., Crosley, C. J., Graf, W. D., Joseph, S. A., Kelfer, H. M., & Raju, G. P. (2010). B cell depletion therapy for new-onset opsoclonus-myoclonus. Mov Disord, 25(2), 238–242. https://doi.org/10.1002/mds.22941.

    Article  PubMed  Google Scholar 

  17. Shams’ili, S., de Beukelaar, J., Gratama, J. W., Hooijkaas, H., van den Bent, M., van’t Veer, M., & Sillevis Smitt, P. (2006). An uncontrolled trial of rituximab for antibody associated paraneoplastic neurological syndromes. J Neurol, 253(1), 16–20. https://doi.org/10.1007/s00415-005-0882-0.

    Article  CAS  PubMed  Google Scholar 

  18. Honnorat, J., Didelot, A., Karantoni, E., Ville, D., Ducray, F., Lambert, L., Deiva, K., Garcia, M., Pichit, P., Cavillon, G., Rogemond, V., DeLattre, J., & Tardieu, M. (2013). Autoimmune limbic encephalopathy and anti-Hu antibodies in children without cancer. Neurology, 80(24), 2226–2232. https://doi.org/10.1212/WNL.0b013e318296e9c3.

    Article  CAS  PubMed  Google Scholar 

  19. Florance-Ryan, N., & Dalmau, J. (2010). Update on anti-N-methyl-D-aspartate receptor encephalitis in children and adolescents. Curr Opin Pediatr, 22(6), 739–744. https://doi.org/10.1097/MOP.0b013e3283402d2f.

    Article  PubMed  Google Scholar 

  20. Lebas, A., Husson, B., Didelot, A., Honnorat, J., & Tardieu, M. (2010). Expanding spectrum of encephalitis with NMDA receptor antibodies in young children. J Child Neurol, 25(6), 742–745. https://doi.org/10.1177/0883073809343319.

    Article  PubMed  Google Scholar 

  21. Haberlandt, E., Bast, T., Ebner, A., Holthausen, H., Kluger, G., Kravljanac, R., Kröll-Seger, J., Kurlemann, G., Makowski, C., Rostasy, K., Tuschen-Hofstätter, E., Weber, G., Vincent, A., & Bien, C. G. (2011). Limbic encephalitis in children and adolescents. Arch Dis Child, 96(2), 186–191. https://doi.org/10.1136/adc.2010.183897.

    Article  CAS  PubMed  Google Scholar 

  22. Nosadini M, Toldo I, Tascini B, Bien CG, Parmeggiani L, De Gaspari P, … Sartori S (2019). LGI1 and CASPR2 autoimmunity in children: systematic literature review and report of a young girl with Morvan syndrome. J Neuroimmunol, 335, 577008. doi:https://doi.org/10.1016/J.JNEUROIM.2019.577008.

  23. Nikolaus, M., Jackowski-Dohrmann, S., Prüss, H., Schuelke, M., & Knierim, E. (2018). Morvan syndrome associated with CASPR2 and LGI1 antibodies in a child. Neurology, 90(4), 183–185. https://doi.org/10.1212/WNL.0000000000004861.

    Article  PubMed  Google Scholar 

  24. Allen, N. M., McKeon, A., O’Rourke, D. J., O’Meara, A., & King, M. D. (2012). Excessive blinking and ataxia in a child with occult neuroblastoma and voltage-gated potassium channel antibodies. Pediatrics, 129(5), e1348–e1352. https://doi.org/10.1542/peds.2011-2690.

    Article  PubMed  Google Scholar 

  25. Rosenfeld, M. R. (2018). Paraneoplastic syndromes affecting the spinal cord and dorsal root ganglia. Up To Date, 12, 1–12.

    Google Scholar 

  26. Sharp, L., & Vernino, S. (2012). Paraneoplastic neuromuscular disorders. Muscle Nerve, 46(6), 839–840. https://doi.org/10.1002/mus.23502.

    Article  Google Scholar 

  27. Amini, A., Lang, B., Heaney, D., & Irani, S. R. (2016). Multiple sequential antibody-associated syndromes with a recurrent mutated neuroblastoma. Neurology, 87(6), 634–636. https://doi.org/10.1212/WNL.0000000000002945.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Younes-Mhenni S, Janier MF, Cinotti L, Antoine JC, Tronc F, Cottin V, … Honnorat J (2004). FDG-PET improves tumour detection in patients with paraneoplastic neurological syndromes. Brain, 127(10), 2331–2338. doi:https://doi.org/10.1093/brain/awh247.

  29. Linke, R., Schroeder, M., Helmberger, T., & Voltz, R. (2004). Antibody-positive paraneoplastic neurologic syndromes: Value of CT and PET for tumor diagnosis. Neurology, 63(2), 282–286. https://doi.org/10.1212/01.WNL.0000129983.06983.4E.

    Article  PubMed  Google Scholar 

  30. Blaes, F., Pike, M. G., & Lang, B. (2008). Autoantibodies in childhood opsoclonus-myoclonus syndrome. J Neuroimmunol, 201, 221–226. https://doi.org/10.1016/j.jneuroim.2008.05.033.

    Article  CAS  PubMed  Google Scholar 

  31. van Vuurden, D. G., Plötz, F. B., de Jong, M., Bokenkamp, A., & van Wijk, J. A. E. (2005). Therapeutic total plasma exchange in a child with neuroblastoma-related anti-Hu syndrome. Pediatr Nephrol, 20(11), 1655–1656. https://doi.org/10.1007/s00467-005-2004-8.

    Article  PubMed  Google Scholar 

  32. Sillevis Smitt, P., Grefkens, J., De Leeuw, B., Van Den Bent, M., Van Putten, W., Hooijkaas, H., & Vecht, C. (2002). Survival and outcome in 73 anti-Hu positive patients with paraneoplastic encephalomyelitis/sensory neuronopathy. J Neurol, 249(6), 745–753. https://doi.org/10.1007/s00415-002-0706-4.

    Article  PubMed  Google Scholar 

  33. Chong, C., Soon, D. T. L., & Yeo, L. L. L. (2019). Opsoclonus - myoclonus syndrome. J Clin Neurosci, 61, 254–255. https://doi.org/10.1016/j.jocn.2018.10.099.

    Article  Google Scholar 

  34. Tate, E. D., Allison, T. J., Pranzatelli, M. R., & Verhulst, S. J. (2005). Neuroepidemiologic trends in 105 US cases of pediatric opsoclonus-myoclonus syndrome. J Pediatr Oncol Nurs, 22(1), 8–19. https://doi.org/10.1177/1043454204272560.

    Article  PubMed  Google Scholar 

  35. Morales La Madrid, A., Rubin, C. M., Kohrman, M., Pytel, P., & Cohn, S. L. (2012). Opsoclonus-myoclonus and anti-Hu positive limbic encephalitis in a patient with neuroblastoma. Pediatr Blood Cancer, 58(3), 472–474. https://doi.org/10.1002/pbc.23131.

    Article  PubMed  Google Scholar 

  36. Fisher, P. G., Wechsler, D. S., & Singer, H. S. (1994). Anti-Hu antibody in a neuroblastoma-associated paraneoplastic syndrome. Pediatr Neurol, 10(4), 309–312. https://doi.org/10.1016/0887-8994(94)90127-9.

    Article  CAS  PubMed  Google Scholar 

  37. Wilfong, A. A., Parke, J. T., & McCrary, J. A. (1992). Opsoclonus-myoclonus with Beckwith-Wiedemann syndrome and hepatoblastoma. Pediatr Neurol, 8(1), 77–79. https://doi.org/10.1016/0887-8994(92)90060-c.

    Article  CAS  PubMed  Google Scholar 

  38. Swart, J. F., De Kraker, J., & Van der Lely, N. (2002). Metaiodobenzylguanidine total-body scintigraphy required for revealing occult neuroblastoma in opsoclonus-myoclonus syndrome. Eur J Pediatr, 161(5), 255–258. https://doi.org/10.1007/s00431-002-0934-8.

    Article  PubMed  Google Scholar 

  39. McGarvey, C. K., Applegate, K., Lee, N. D., & Sokol, D. K. (2006). False-positive metaiodobenzylguanidine scan for neuroblastoma in a child with opsoclonus-myoclonus syndrome treated with adrenocorticotropic hormone (ACTH). J Child Neurol, 21(7), 606–610. https://doi.org/10.1177/08830738060210070801.

    Article  PubMed  Google Scholar 

  40. Brunklaus, A., Pohl, K., Zuberi, S. M., & De Sousa, C. (2012). Investigating neuroblastoma in childhood opsoclonus-myoclonus syndrome. Arch Dis Child. https://doi.org/10.1136/adc.2010.204792.

  41. Baizabal-Carvallo, J. F., Stocco, A., Muscal, E., & Jankovic, J. (2013). The spectrum of movement disorders in children with anti-NMDA receptor encephalitis. Mov Disord, 28(4), 543–547. https://doi.org/10.1002/mds.25354.

    Article  PubMed  Google Scholar 

  42. Mohammad, S. S., Fung, V. S. C., Grattan-Smith, P., Gill, D., Pillai, S., Ramanathan, S., et al. (2014). Movement disorders in children with anti-NMDAR encephalitis and other autoimmune encephalopathies. Mov Disord, 29(12), 1539–1542. https://doi.org/10.1002/mds.25999.

    Article  CAS  PubMed  Google Scholar 

  43. Yeshokumar, A. K., Sun, L. R., Klein, J. L., Baranano, K. W., & Pardo, C. A. (2016). Gait disturbance as the presenting symptom in young children with anti-NMDA receptor encephalitis. Pediatrics, 138(3), e20160901. https://doi.org/10.1542/peds.2016-0901.

    Article  PubMed  Google Scholar 

  44. Darnell, R. B. (2007). NMDA receptor as a target in paraneoplastic encephalitis. Ann Neurol, 61(1), 3–4. https://doi.org/10.1002/ana.21074.

    Article  CAS  PubMed  Google Scholar 

  45. Dalmau, J., Tüzün, E., Wu, H., & Masjuan, J. (2007). Paraneoplastic anti–N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma. Ann Neurol, 61(1), 25–36.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Dalmau, J., Gleichman, A. J., Hughes, E. G., Rossi, J. E., Peng, X., Lai, M., Dessain, S. K., Rosenfeld, M. R., Balice-Gordon, R., & Lynch, D. R. (2008). Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol, 7(12), 1091–1098. https://doi.org/10.1016/S1474-4422(08)70224-2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Kunstreich, M., Kreth, J. H., Oommen, P. T., Schaper, J., Karenfort, M., Aktas, O., Tibussek, D., Distelmaier, F., Borkhardt, A., & Kuhlen, M. (2017). Paraneoplastic limbic encephalitis with SOX1 and PCA2 antibodies and relapsing neurological symptoms in an adolescent with Hodgkin lymphoma. Eur J Paediatr Neurol, 21(4), 661–665. https://doi.org/10.1016/j.ejpn.2017.03.005.

    Article  CAS  PubMed  Google Scholar 

  48. Chan, D. W. S., Thomas, T., Lim, M., Ling, S., Woodhall, M., & Vincent, A. (2017). Focal status epilepticus and progressive dyskinesia: a novel phenotype for glycine receptor antibody-mediated neurological disease in children. Eur J Paediatr Neurol, 21(2), 414–417. https://doi.org/10.1016/j.ejpn.2016.08.013.

    Article  CAS  PubMed  Google Scholar 

  49. Spatola, M., Sabater, L., Planagumà, J., Martínez-Hernandez, E., Armangué, T., Prüss, H., Iizuka, T., Caparó Oblitas, R. L., Antoine, J. C., Li, R., Heaney, N., Tubridy, N., Munteis Olivas, E., Rosenfeld, M. R., Graus, F., & Dalmau, J. (2018). Encephalitis with mGluR5 antibodies: symptoms and antibody effects. Neurology, 90(22), e1964–e1972. https://doi.org/10.1212/WNL.0000000000005614.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  50. Rudock R, Helis J, & Mar SS (2017). Anti-glutamic acid decarboxylase limbic encephalitis. In Pediatric demyelinating diseases of the central nervous system and their mimics (pp. 67–73). Springer International Publishing. doi:https://doi.org/10.1007/978-3-319-61407-6_9.

  51. Gresa-Arribas, N., Titulaer, M. J., Torrents, A., Aguilar, E., McCracken, L., Leypoldt, F., Gleichman, A. J., Balice-Gordon, R., Rosenfeld, M. R., Lynch, D., Graus, F., & Dalmau, J. (2014). Antibody titres at diagnosis and during follow-up of anti-NMDA receptor encephalitis: a retrospective study. Lancet Neurol, 13(2), 167–177. https://doi.org/10.1016/S1474-4422(13)70282-5.

    Article  CAS  PubMed  Google Scholar 

  52. Rosenfeld, M. R., & Dalmau, J. (2011). Anti-NMDA-receptor encephalitis and other synaptic autoimmune disorders. Curr Treat Options Neurol, 13(3), 324–332. https://doi.org/10.1007/s11940-011-0116-y.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Gungor, S., Kilic, B., Arslan, M., Ozgen, U., & Dalmau, J. (2017). Hodgkin’s lymphoma associated with paraneoplastic cerebellar degeneration in children: a case report and review of the literature. Childs Nerv Syst, 33(3), 509–512. https://doi.org/10.1007/s00381-016-3284-y.

    Article  PubMed  Google Scholar 

  54. Nakamura, T., Morimoto, N., Goto, F., Shioda, Y., Hoshino, H., Kubota, M., & Taiji, H. (2012). Langerhans cell histiocytosis with disequilibrium. Auris Nasus Larynx, 39(6), 627–630. https://doi.org/10.1016/j.anl.2012.01.003.

    Article  PubMed  Google Scholar 

  55. Emir, S., Tezer Kutluk, M., Göğüş, S., & Büyükpamukçu, M. (2000). Paraneoplastic cerebellar degeneration and horner syndrome: association of two uncommon findings in a child with hodgkin disease. Am J Pediatr Hematol/Oncol, 22(2), 158–161. https://doi.org/10.1097/00043426-200003000-00015.

    Article  CAS  Google Scholar 

  56. Greenlee, J. E. (2013). Treatment of paraneoplastic cerebellar degeneration. Curr Treat Options Neurol, 15(2), 185–200. https://doi.org/10.1007/s11940-012-0215-4.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Ojeda, V. J., & Ojeda, V. J. (1984). Necrotizing myelopathy associated with malignancy. a clinicopathologic study of two cases and literature review. Cancer, 53(5), 1115–1123. https://doi.org/10.1002/1097-0142(19840301)53:5<1115::aid-cncr2820530517>3.0.co;2-w.

    Article  CAS  PubMed  Google Scholar 

  58. Pittock, S. J., & Lennon, V. A. (2008). Aquaporin-4 autoantibodies in a paraneoplastic context. Arch Neurol, 65(5), 629–632. https://doi.org/10.1001/archneur.65.5.629.

    Article  PubMed  Google Scholar 

  59. de Buys Roessingh, A. S., Loriot, M. H., Wiesenauer, C., & Lallier, M. (2009). Lambert-Eaton myasthenic syndrome revealing an abdominal neuroblastoma. J Pediatr Surg, 44(8), E5–E7. https://doi.org/10.1016/j.jpedsurg.2009.04.023.

    Article  PubMed  Google Scholar 

  60. Sun, L. R., & Cooper, S. (2018). Neurological complications of the treatment of pediatric neoplastic disorders. Pediatr Neurol, 85, 33–42. https://doi.org/10.1016/j.pediatrneurol.2018.05.011.

    Article  PubMed  Google Scholar 

  61. Küper, M., & Timmann, D. (2013). Cerebellar mutism. Brain Lang, 127(3), 327–333. https://doi.org/10.1016/J.BANDL.2013.01.001.

    Article  PubMed  Google Scholar 

  62. Neil, E. C., Hanmantgad, S., & Khakoo, Y. (2016). Neurological complications of pediatric cancer. J Child Neurol, 31(12), 1412–1420. https://doi.org/10.1177/0883073815620673.

    Article  PubMed  Google Scholar 

  63. Newton HB (2012). Neurological complications of chemotherapy to the central nervous system. In Handbook of clinical neurology (Vol. 105, pp. 903–916). Elsevier B.V. doi:https://doi.org/10.1016/B978-0-444-53502-3.00031-8.

  64. Staff, N. P, Grisold, A., Grisold, W., & Windebank, A. J. (2017). Chemotherapy-induced peripheral neuropathy: a current review. Ann Neurol, 81(6), 772–781. https://doi.org/10.1002/ana.24951.

    Article  CAS  Google Scholar 

  65. Schiff, D., Wen, P. Y., & van den Bent, M. J. (2009). Neurological adverse effects caused by cytotoxic and targeted therapies. Nat Rev Clin Oncol, 6(10), 596–603. https://doi.org/10.1038/nrclinonc.2009.128.

    Article  PubMed  Google Scholar 

  66. Wick, W., Hertenstein, A., & Platten, M. (2016). Neurological sequelae of cancer immunotherapies and targeted therapies. Lancet Oncol, 17(12), e529–e541. https://doi.org/10.1016/S1470-2045(16)30571-X.

    Article  PubMed  Google Scholar 

  67. Cordelli, D. M., Masetti, R., Zama, D., Toni, F., Castelli, I., Ricci, E., Franzoni, E., & Pession, A. (2017). Central nervous system complications in children receiving chemotherapy or hematopoietic stem cell transplantation. Front Pediatr, 5, 105. https://doi.org/10.3389/fped.2017.00105.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Carson KR, Newsome SD, Kim EJ, Wagner-Johnston ND, Von Geldern G, Moskowitz CH, … Bennett CL (2014). Progressive multifocal leukoencephalopathy associated with brentuximab vedotin therapy: a report of 5 cases from the Southern Network on Adverse Reactions (SONAR) project. Cancer, 120(16), 2464–2471. doi:https://doi.org/10.1002/cncr.28712.

  69. Toxicology and Environmental Health Information Program (TEHIP). (2019). TOXNET. National Library of Medicine. Retrieved November 26, 2019, from https://toxnet.nlm.nih.gov/index.html Accessed 12/2/2019.

  70. Aspesberro, F., Milewski, L. S., & Brogan, T. V. (2014). Acute central nervous system complications in pediatric hematopoietic stem cell patients. J Pediatr Intensive Care, 3, 169–181. https://doi.org/10.3233/PIC-14100.

    Article  PubMed  Google Scholar 

  71. Tibussek D, Natesirinilkul R, Sun LR, Wasserman, B. A., Brandao LR, deVeber G, … deVeber G (2016). Severe cerebral vasospasm and childhood arterial ischemic stroke after intrathecal cytarabine. Pediatrics, 137(2), e20152143–e20152143. doi:https://doi.org/10.1542/peds.2015-2143.

  72. Sait, S., & Modak, S. (2017). Anti-GD2 immunotherapy for neuroblastoma. Expert Rev Anticancer Ther, 17(10), 889–904. https://doi.org/10.1080/14737140.2017.1364995.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Han, R., Yang, Y. M., Dietrich, J., Luebke, A., Mayer-Pröschel, M., & Noble, M. (2008). Systemic 5-fluorouracil treatment causes a syndrome of delayed myelin destruction in the central nervous system. J Biol, 7(4), 12. https://doi.org/10.1186/jbiol69.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Ewins, K., Malone, A., Phelan, E., Webb, D., McHugh, J. C., & Smith, O. (2017). Nelarabine-induced peripheral and central neurotoxicity: can sequential MRI brain imaging help to define its natural history? Br J Haematol, 179(2), 294–297. https://doi.org/10.1111/bjh.14921.

    Article  PubMed  Google Scholar 

  75. Judge, C., Moheb, N., & Melinosky, C. (2019). Nilotinib-associated demyelinating disease. Neurology, 92(Suppl 15), P2.2–P093.

    Google Scholar 

  76. Dombi E, Baldwin A, Marcus LJ, Fisher MJ, Weiss B, Kim A, … Widemann BC (2016). Activity of selumetinib in neurofibromatosis type 1-related plexiform neurofibromas. N Eng J Med, 375(26), 2550–2560. doi:https://doi.org/10.1056/NEJMoa1605943.

  77. Grace, R. F., Dahlberg, S. E., Neuberg, D., Sallan, S. E., Connors, J. M., Neufeld, E. J., Deangelo, D. J., & Silverman, L. B. (2011). The frequency and management of asparaginase-related thrombosis in paediatric and adult patients with acute lymphoblastic leukaemia treated on Dana-Farber Cancer Institute consortium protocols. Br J Haematol, 152(4), 452–459. https://doi.org/10.1111/j.1365-2141.2010.08524.x.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Mitchell LG, Andrew M, Abshire T, Halton J, Anderson R, Cherrick I, … Way C (2003). A prospective cohort study determining the prevalence of thrombotic events in children with acute lymphoblastic leukemia and a central venous line who are treated with l-asparaginase: results of the Prophylactic antithrombin Replacement in Kids with Acute Lymphoblastic Leukemia Treated with Asparaginase (PARKAA) study. Cancer, 97(2), 508–516. doi:https://doi.org/10.1002/cncr.11042.

  79. Caruso, V., Iacoviello, L., Di Castelnuovo, A., Storti, S., Mariani, G., De Gaetano, G., & Donati, M. B. (2006). Thrombotic complications in childhood acute lymphoblastic leukemia: a meta-analysis of 17 prospective studies comprising 1752 pediatric patients. Blood. https://doi.org/10.1182/blood-2006-04-015511.

  80. Greiner J, Schrappe M, Claviez A, Zimmermann M, Niemeyer C, Kolb R, … Möricke A (2019). THROMBOTECT – a randomized study comparing low molecular weight heparin, antithrombin and unfractionated heparin for thromboprophylaxis during induction therapy of acute lymphoblastic leukemia in children and adolescents. Haematologica, 104(4), 756–765. doi:https://doi.org/10.3324/haematol.2018.194175.

  81. Malhotra, P., Jain, S., & Kapoor, G. (2018). Symptomatic cerebral sinovenous thrombosis associated with l-asparaginase in children with acute lymphoblastic leukemia: a single institution experience over 17 years. J Pediatr Hematol Oncol, 40(7), e450–e453. https://doi.org/10.1097/MPH.0000000000001127.

    Article  CAS  PubMed  Google Scholar 

  82. Nicolao, P., & Giometto, B. (2003). Neurological toxicity of ifosfamide. Oncology, 65(Suppl 2), 11–16. https://doi.org/10.1159/000073352.

    Article  CAS  PubMed  Google Scholar 

  83. Taupin, D., Racela, R., & Friedman, D. (2014). Ifosfamide chemotherapy and nonconvulsive status epilepticus: case report and review of the literature. Clin EEG Neurosci, 45(3), 222–225. https://doi.org/10.1177/1550059413500777.

    Article  PubMed  Google Scholar 

  84. Bhojwani, D., Sabin, N. D., Pei, D., Yang, J. J., Khan, R. B., Panetta, J. C., Krull, K. R., Inaba, H., Rubnitz, J. E., Metzger, M. L., Howard, S. C., Ribeiro, R. C., Cheng, C., Reddick, W. E., Jeha, S., Sandlund, J. T., Evans, W. E., Pui, C. H., & Relling, M. V. (2014). Methotrexate-induced neurotoxicity and leukoencephalopathy in childhood acute lymphoblastic leukemia. J Clin Oncol, 32(9), 949–959. https://doi.org/10.1200/JCO.2013.53.0808.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  85. Inaba, H., Khan, R. B., Laningham, F. H., Crews, K. R., Pui, C. H., & Daw, N. C. (2008). Clinical and radiological characteristics of methotrexate-induced acute encephalopathy in pediatric patients with cancer. Ann Oncol, 19(1), 178–184. https://doi.org/10.1093/annonc/mdm466.

    Article  CAS  PubMed  Google Scholar 

  86. Cheung, Y. T., Sabin, N. D., Reddick, W. E., Bhojwani, D., Liu, W., Brinkman, T. M., Glass, J. O., Hwang, S. N., Srivastava, D., Pui, C. H., Robison, L. L., Hudson, M. M., & Krull, K. R. (2016). Leukoencephalopathy and long-term neurobehavioural, neurocognitive, and brain imaging outcomes in survivors of childhood acute lymphoblastic leukaemia treated with chemotherapy: a longitudinal analysis. Lancet Haematol, 3(10), 456–466. https://doi.org/10.1016/S2352-3026(16)30110-7.

    Article  Google Scholar 

  87. Koh, S., Nelson, M. D., Kovanlikaya, A., & Chen, L. S. (1999). Anterior lumbosacral radiculopathy after intrathecal methotrexate treatment. Pediatr Neurol, 21(2), 576–578. https://doi.org/10.1016/S0887-8994(99)00040-5.

    Article  CAS  PubMed  Google Scholar 

  88. Junna, M. R., & Rabinstein, A. A. (2007). Tacrolimus induced leukoencephalopathy presenting with status epilepticus and prolonged coma. J Neurol Neurosurg Psychiatry, 78(12), 1410–1411. https://doi.org/10.1136/jnnp.2007.121806.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Antoine, J. C., & Camdessanché, J. P. (2007). Peripheral nervous system involvement in patients with cancer. Lancet Neurol, 6(1), 75–86. https://doi.org/10.1016/S1474-4422(06)70679-2.

    Article  PubMed  Google Scholar 

  90. Tang, J.-H., Tian, J.-M., Sheng, M., Hu, S.-Y., Li, Y., Zhang, L.-Y., Gu, Q., & Wang, Q. (2016). Study of posterior reversible encephalopathy syndrome in children with acute lymphoblastic leukemia after induction chemotherapy. J Child Neurol, 31(3), 279–284. https://doi.org/10.1177/0883073815589758.

    Article  PubMed  Google Scholar 

  91. Landi, D. B., Thompson, E. M., & Ashley, D. M. (2018). Immunotherapy for pediatric brain tumors. Neuroimmunol Neuroinflamm, 5, 29. https://doi.org/10.20517/2347-8659.2018.35.

    Article  CAS  Google Scholar 

  92. Kabir, T. F., Chauhan, A., Anthony, L., & Hildebrandt, G. C. (2018). Immune checkpoint inhibitors in pediatric solid tumors: status in 2018. Ochsner J, 18(4), 370–376. https://doi.org/10.31486/toj.18.0055.

    Article  PubMed  PubMed Central  Google Scholar 

  93. AlHarbi M, Mobark NA, AlMubarak L, Aljelaify R, AlSaeed M, Almutairi A, … Abedalthagafi M (2018). Durable response to nivolumab in a pediatric patient with refractory glioblastoma and constitutional biallelic mismatch repair deficiency Saudi human genome project View project medulloblastoma View project, 23(12), 1401–1406. doi:https://doi.org/10.1634/theoncologist.2018-0163.

  94. Gorsi H, Malicki DM, Barsan, V, Tumblin M, Yeh-Nayre L, Milburn M, … Crawford JR (2019). Nivolumab in the treatment of recurrent or refractory pediatric brain tumors: a single institutional experience. J Pediatr Hematol/Oncol, 41(4), e235–241. doi:https://doi.org/10.1097/MPH.0000000000001339.

  95. Wang, S. S., Bandopadhayay, P., & Jenkins, M. R. (2019). Towards immunotherapy for pediatric brain tumors. Trends Immunol, 40(8), 748–761. https://doi.org/10.1016/j.it.2019.05.009.

    Article  CAS  PubMed  Google Scholar 

  96. Williams TJ, Benavides DR, Patrice, K A, Dalmau JO, De Ávila AL R, Le DT, … Mowry EM (2016). Association of autoimmune encephalitis with combined immune checkpoint inhibitor treatment for metastatic cancer. JAMA Neurol, 73(8), 928–933. doi:https://doi.org/10.1001/jamaneurol.2016.1399.

  97. Zekeridou, A., & Lennon, V. A. (2019). Neurologic autoimmunity in the era of checkpoint inhibitor cancer immunotherapy. Mayo Clin Proc, 94(9), 1865–1878. https://doi.org/10.1016/j.mayocp.2019.02.003.

    Article  PubMed  Google Scholar 

  98. Dalakas, M. C. (2018). Neurological complications of immune checkpoint inhibitors: what happens when you ‘take the brakes off’ the immune system. Ther Adv Neurol Disord, 11, 1756286418799864. https://doi.org/10.1177/1756286418799864.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  99. Brudno, J. N., & Kochenderfer, J. N. (2019). Recent advances in CAR T-cell toxicity: mechanisms, manifestations and management. Blood Rev, 34, 45–55. https://doi.org/10.1016/j.blre.2018.11.002.

    Article  CAS  PubMed  Google Scholar 

  100. Gust, J., Hay KA, Hanafi L A, Li D, Myerson D, Gonzalez-Cuyar LF, … Turtle CJ (2017). Endothelial activation and blood–brain barrier disruption in neurotoxicity after adoptive immunotherapy with CD19 CAR-T cells. Cancer Discov doi:https://doi.org/10.1158/2159-8290.CD-17-0698.

  101. Hay, K. A. (2018). Cytokine release syndrome and neurotoxicity after CD19 chimeric antigen receptor-modified (CAR-) T cell therapy. Br J Haematol. https://doi.org/10.1111/bjh.15644.

  102. Santomasso BD, Park JH, Salloum D, Riviere, I., Flynn J, Mead E, … Brentjens RJ (2018). Clinical and biological correlates of neurotoxicity associated with car t-cell therapy in patients with B-cell acute lymphoblastic leukemia. Cancer Discov. doi:https://doi.org/10.1158/2159-8290.CD-17-1319.

  103. Willis, M. D., & Robertson, N. P. (2019). Neurotoxicity of novel cancer immunotherapies. J Neurol, 266, 2087–2089. https://doi.org/10.1007/s00415-019-09444-4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  104. Gust, J., Taraseviciute, A., & Turtle, C. J. (2018). Neurotoxicity associated with CD19-targeted CAR-T cell therapies. CNS Drugs, 32(12), 1091–1101. https://doi.org/10.1007/s40263-018-0582-9.

    Article  PubMed  PubMed Central  Google Scholar 

  105. Le RQ, Li L, Yuan W, Shord SS, Nie L, Habtemariam BA, … Pazdur R (2018). FDA approval summary: tocilizumab for treatment of chimeric antigen receptor T cell-induced severe or life-threatening cytokine release syndrome. The Oncologist, 23(8), 943–947. doi:https://doi.org/10.1634/theoncologist.2018-0028.

  106. Reynolds, M. R., Haydon, D. H., Caird, J., & Leonard, J. R. (2016). Radiation-induced moyamoya syndrome after proton beam therapy in the pediatric patient: a case series. Pediatr Neurosurg, 51(6), 297–301. https://doi.org/10.1159/000446075.

    Article  PubMed  Google Scholar 

  107. Meadows, A. T., Massari, D. J., Fergusson, J., Gordon, J., Littman, P., & Moss, K. (1981). Declines in IQ scores and cognitive dysfunctions in children with acute lymphocytic leukaemia treated with cranial irradiation. Lancet, 2(8254), 1015–1018. https://doi.org/10.1016/S0140-6736(81)91216-2.

    Article  CAS  PubMed  Google Scholar 

  108. Amirjamshidi, A., & Abbassioun, K. (2000). Radiation-induced tumors of the central nervous system occurring in childhood and adolescence. Childs Nerv Syst, 16(7), 390–397. https://doi.org/10.1007/s003819900125.

    Article  CAS  PubMed  Google Scholar 

  109. Gastelum, E., Sear, K., Hills, N., Roddy, E., Randazzo, D., Chettout, N., Hess, C., Cotter, J., Haas-Kogan, D. A., Fullerton, H., & Mueller, S. (2015). Rates and characteristics of radiographically detected intracerebral cavernous malformations after cranial radiation therapy in pediatric cancer patients. J Child Neurol, 30(7), 842–849. https://doi.org/10.1177/0883073814544364.

    Article  PubMed  Google Scholar 

  110. Strenger, V., Sovinz, P., Lackner, H., Dornbusch, H. J., Lingitz, H., Eder, H. G., Moser, A., & Urban, C. (2008). Intracerebral cavernous hemangioma after cranial irradiation in childhood: incidence and risk factors. Strahlenther Onkol, 184(5), 276–280. https://doi.org/10.1007/s00066-008-1817-3.

    Article  PubMed  Google Scholar 

  111. Lew, S. M., Morgan, J. N., Psaty, E., Lefton, D. R., Allen, J. C., & Abbott, R. (2006). Cumulative incidence of radiation-induced cavernomas in long-term survivors of medulloblastoma. J Neurosurg, 104(Suppl 2), 103–107. https://doi.org/10.3171/ped.2006.104.2.6.

    Article  PubMed  Google Scholar 

  112. Sciubba, D. M., Gallia, G. L., Recinos, P., Garonzik, I. M., & Clatterbuck, R. E. (2006). Intracranial aneurysm following radiation therapy during childhood for a brain tumor: case report and review of the literature. J Neurosurg, 105(2), 134–139. https://doi.org/10.3171/ped.2006.105.2.134.

    Article  PubMed  Google Scholar 

  113. Fan, E. P., Heiber, G., Gerard, E. E., & Schuele, S. (2018). Stroke-like migraine attacks after radiation therapy: a misnomer? Epilepsia, 59(1), 259–268. https://doi.org/10.1111/epi.13963.

    Article  PubMed  Google Scholar 

  114. Wai, K., Balabanski, A., Chia, N., & Kleinig, T. (2017). Reversible hemispheric hypoperfusion in two cases of SMART syndrome. J Clin Neurosci, 43, 146–148. https://doi.org/10.1016/j.jocn.2017.05.013.

    Article  PubMed  Google Scholar 

  115. Stubblefield, M. D. (2017). Neuromuscular complications of radiation therapy. Muscle Nerve, 56(6), 1031–1040. https://doi.org/10.1002/mus.25778.

    Article  PubMed  Google Scholar 

  116. Neglia, J. P., Robison, L. L., Stovall, M., Liu, Y., Packer, R. J., Hammond, S., Yasui, Y., Kasper, C. E., Mertens, A. C., Donaldson, S. S., Meadows, A. T., & Inskip, P. D. (2006). New primary neoplasms of the central nervous system in survivors of childhood cancer: a report from the childhood cancer survivor study. J Natl Cancer Inst, 98(21), 1528–1537. https://doi.org/10.1093/jnci/djj411.

    Article  PubMed  Google Scholar 

  117. Schmidt-Hieber, M., Silling, G., Schalk, E., Heinz, W., Panse, J., Penack, O., Christopeit, M., Buchheidt, D., Meyding-Lamadé, U., Hähnel, S., Wolf, H. H., Ruhnke, M., Schwartz, S., & Maschmeyer, G. (2016). CNS infections in patients with hematological disorders (including allogeneic stem-cell transplantation)-guidelines of the infectious DiseasesWorking party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Oncol, 27(7), 1207–1225. https://doi.org/10.1093/annonc/mdw155.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  118. Schoettler, M., Duncan, C., & Lehmann, L. (2019). Severe, persistent neurotoxicity after transplant-associated thrombotic microangiopathy in a pediatric patient despite treatment with eculizumab. Pediatr Transplant, 23(3), e13381. https://doi.org/10.1111/petr.13381.

    Article  PubMed  PubMed Central  Google Scholar 

  119. Callahan, M. J., MacDougall, R. D., Bixby, S. D., Voss, S. D., Robertson, R. L., & Cravero, J. P. (2018). Ionizing radiation from computed tomography versus anesthesia for magnetic resonance imaging in infants and children: patient safety considerations. Pediatr Radiol, 48(1), 21–30. https://doi.org/10.1007/s00247-017-4023-6.

    Article  PubMed  Google Scholar 

  120. Tekes, A., Senglaub, S. S., Ahn, E. S., Huisman, T. A. G. M., & Jackson, E. M. (2018). Ultrafast brain MRI can be used for indications beyond shunted hydrocephalus in pediatric patients. Am J Neuroradiol, 39(8), 1515–1518. https://doi.org/10.3174/ajnr.A5724.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  121. Tuma, R., & DeAngelis, L. M. (2000). Altered mental status in patients with cancer. Arch Neurol, 57(12), 1727–1731. https://doi.org/10.1001/archneur.57.12.1727.

    Article  CAS  PubMed  Google Scholar 

  122. Khan, R. B., Hunt, D. L., Boop, F. A., Sanford, R. A., Merchant, T. E., Gajjar, A., & Kun, L. E. (2005). Seizures in children with primary brain tumors: Incidence and long-term outcome. Epilepsy Res, 64(3), 85–91. https://doi.org/10.1016/j.eplepsyres.2005.03.007.

    Article  PubMed  Google Scholar 

  123. Ibrahim, K., & Appleton, R. E. (2004). Seizures as the presenting symptom of brain tumours in children. Seizure, 13(2), 108–112. https://doi.org/10.1016/S1059-1311(03)00083-9.

    Article  PubMed  Google Scholar 

  124. Glantz MJ, Cole BF, Forsyth PA, Recht LD, Wen PY, Chamberlain MC, … Cairncross JG (2000). Practice parameter: anticonvulsant prophylaxis in patients with newly diagnosed brain tumors: report of the quality standards Subcommittee of the American Academy of neurology. Neurology, 54(10), 1886–1893. doi:https://doi.org/10.1212/WNL.54.10.1886.

  125. Hardesty, D. A., Sanborn, M. R., Parker, W. E., & Storm, P. B. (2011). Perioperative seizure incidence and risk factors in 223 pediatric brain tumor patients without prior seizures: clinical article. J Neurosurg Pediatr. https://doi.org/10.3171/2011.3.PEDS1120.

  126. Patsalos, P. N., & St. Louis, E. K. (2018). The epilepsy prescriber’s guide to antiepileptic drugs (3rd ed.). Cambridge: Cambridge University Press. https://doi.org/10.1017/9781108669399.

    Book  Google Scholar 

  127. The Childhood Brain Tumor Consortium. (1991). The epidemiology of headache among children with brain tumor. Headache in children with brain tumors. J Neuro-Oncol, 10(1), 31–46. https://doi.org/10.1007/bf00151245.

    Article  Google Scholar 

  128. Kirby, S., & Purdy, R. A. (2007). Headache and brain tumors. Curr Neurol Neurosci Rep, 7(2), 110–116. https://doi.org/10.1007/s11910-007-0005-7.

    Article  PubMed  Google Scholar 

  129. Demaree, C. J., Soliz, J. M., & Gebhardt, R. (2016). Cancer seeding risk from an epidural blood patch in patients with leukemia or lymphoma. Pain Med, 18(4), 218. https://doi.org/10.1093/pm/pnw218.

    Article  Google Scholar 

  130. Rusch, R., Schulta, C., Hughes, L., & Withycombe, J. S. (2014). Evidence-based practice recommendations to prevent/manage post-lumbar puncture headaches in pediatric patients receiving intrathecal chemotherapy. J Pediatr Oncol Nurs, 31(4), 230–238. https://doi.org/10.1177/1043454214532026.

    Article  PubMed  Google Scholar 

  131. Lee, L. C.-Y., Sennett, M., & Erickson, J. M. (2007). Prevention and management of post–lumbar puncture headache in pediatric oncology patients. J Pediatr Oncol Nurs, 24(4), 200–207. https://doi.org/10.1177/1043454207303884.

    Article  PubMed  Google Scholar 

  132. Kranick, S. M., Campen, C. J., Kasner, S. E., Kessler, S. K., Zimmerman, R. A., Lustig, R. A., Phillips, P. C., Beslow, L. A., Ichord, R., & Fisher, M. J. (2013). Headache as a risk factor for neurovascular events in pediatric brain tumor patients. Neurology, 80(16), 1452–1456. https://doi.org/10.1212/WNL.0b013e31828cf81e.

    Article  PubMed  PubMed Central  Google Scholar 

  133. Black, D., Bartleson, J., Bell, M., & Lachance, D. (2006). SMART: stroke-like migraine attacks after radiation therapy. Cephalalgia, 26(9), 1137–1142. https://doi.org/10.1111/j.1468-2982.2006.01184.x.

    Article  CAS  PubMed  Google Scholar 

  134. Sporns PB, Sträter R, Minnerup, J, Wiendl H, Hanning U, Chapot R, … Kemmling A (2019). Feasibility, safety, and outcome of endovascular recanalization in childhood stroke: the Save ChildS Study. JAMA Neurol. doi:https://doi.org/10.1001/jamaneurol.2019.3403.

  135. Bigi, S., Dulcey, A., Gralla, J., Bernasconi, C., Melliger, A., Datta, A. N., Arnold, M., Kaesmacher, J., Fluss, J., Hackenberg, A., Maier, O., Weber, J., Poloni, C., Fischer, U., & Steinlin, M. (2018). Feasibility, safety, and outcome of recanalization treatment in childhood stroke. Ann Neurol, 83(6), 1125–1132. https://doi.org/10.1002/ana.25242.

    Article  PubMed  Google Scholar 

  136. Amlie-Lefond, C., & Wainwright, M. S. (2019). Organizing for acute arterial ischemic stroke in children. Stroke, 50(12), 3662–3668. https://doi.org/10.1161/STROKEAHA.119.025497.

    Article  PubMed  Google Scholar 

  137. Furuhata, M., Aihara, Y., Eguchi, S., Horiba, A., Tanaka, M., Komori, T., & Okada, Y. (2014). Pediatric medulloblastoma presenting as cerebellar hemorrhage: a case report. No shinkei geka. Neurol Surg, 42(6), 545–551.

    Google Scholar 

  138. Wilson, M. P., Johnson, E. S., Hawkins, C., Atkins, K., Alshaya, W., & Pugh, J. A. (2016). Hemorrhagic presentations of cerebellar pilocytic astrocytomas in children resulting in death: report of 2 cases. J Neurosurg Pediatr, 17(4), 446–452. https://doi.org/10.3171/2015.10.PEDS1580.

    Article  PubMed  Google Scholar 

  139. Packer, R. J., Rorke, L. B., Lange, B. J., Siegel, K. R., & Evans, A. E. (1985). Cerebrovascular accidents in children with cancer. Pediatrics, 76(2), 194–201.

    CAS  PubMed  Google Scholar 

  140. Bajzar, L., Chan, A. K., Massicotte, M. P., & Mitchell, L. G. (2006). Thrombosis in children with malignancy. Curr Opin Pediatr, 18(1), 1–9. https://doi.org/10.1097/01.mop.0000193270.09001.ea.

    Article  PubMed  Google Scholar 

  141. Herrlinger, U., Schabet, M., Bitzer, M., Petersen, D., & Krauseneck, P. (1999). Primary central nervous system lymphoma: from clinical presentation to diagnosis. J Neuro-Oncol, 43(3), 219–226. https://doi.org/10.1023/A:1006298201101.

    Article  CAS  Google Scholar 

  142. Bühring, U., Herrlinger, U., Krings, T., Thiex, R., Weller, M., & Küker, W. (2001). MRI features of primary central nervous system lymphomas at presentation. Neurology, 57(3), 393–396. https://doi.org/10.1212/wnl.57.3.393.

    Article  PubMed  Google Scholar 

  143. Bjornard, K. L., Leventaki, V., Nichols, K. E., Sandlund, J. T., Prockop, S., & Ehrhardt, M. J. (2018). Two-year-old female with EBV-positive diffuse large B-cell lymphoma and subsequent CNS involvement with neurolymphomatosis. Pediatr Blood Cancer, 65(12), e27415. https://doi.org/10.1002/pbc.27415.

    Article  PubMed  PubMed Central  Google Scholar 

  144. Grisariu S, Avni B, Batchelor T T, Bent MJ van den, Bokstein F, Schiff, D, … Siegal T (2010). Neurolymphomatosis: an international primary CNS lymphoma collaborative group report. Blood, 115(24), 5005–5011. doi:https://doi.org/10.1182/BLOOD-2009-12-258210.

  145. Grisold, W., Cavaletti, G., & Windebank, A. J. (2012). Peripheral neuropathies from chemotherapeutics and targeted agents: diagnosis, treatment, and prevention. Neuro-Oncology, 14(suppl 4), v45–v54. https://doi.org/10.1093/neuonc/nos203.

    Article  CAS  Google Scholar 

  146. Ness, K. K., Hudson, M. M., Pui, C. H., Green, D. M., Krull, K. R., Huang, T. T., Robison, L. L., & Morris, E. B. (2012). Neuromuscular impairments in adult survivors of childhood acute lymphoblastic leukemia: associations with physical performance and chemotherapy doses. Cancer, 118(3), 828–838. https://doi.org/10.1002/cncr.26337.

    Article  PubMed  Google Scholar 

  147. Chu, S. H., Lee, Y. J., Lee, E. S., Geng, Y., Wang, X. S., & Cleeland, C. S. (2015). Current use of drugs affecting the central nervous system for chemotherapy-induced peripheral neuropathy in cancer patients: A systematic review. Support Care Cancer, 23(2), 513–524. https://doi.org/10.1007/s00520-014-2408-8.

    Article  PubMed  Google Scholar 

  148. Hou, S., Huh, B., Kim, H. K., Kim, K. H., & Abdi, S. (2018). Treatment of chemotherapy-induced peripheral neuropathy: systematic review and recommendations. Pain Physician, 21(6), 571–592.

    PubMed  Google Scholar 

Download references

Acknowledgments

We thank Stacy Cooper for her assistance with the chemotherapy section of this manuscript.

Author information

Authors and Affiliations

  1. Department of Neurology, Johns Hopkins Hospital, 200 N Wolfe St Suite 2158, Baltimore, MD, 21287, USA

    Caren Armstrong & Lisa R. Sun

Authors
  1. Caren Armstrong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lisa R. Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

C.A. and L.S. wrote the manuscript.

Corresponding author

Correspondence to Lisa R. Sun.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Armstrong, C., Sun, L.R. Neurological complications of pediatric cancer. Cancer Metastasis Rev 39, 3–23 (2020). https://doi.org/10.1007/s10555-020-09847-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10555-020-09847-0

Keywords

Search

Navigation