ICNC Abstracts, ICNC 2018

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The neurological manifestations of lympho-haematopoietic malignancies
Dr Sonam Rameshchandra Kothari, Dr Shilpa Kulkarni, Dr Meghana Nadiger, Dr Anaita Udwadia Hegde, Dr K N Shah

Last modified: 2018-09-09

Abstract


Hematological malignancies are common in childhood.  During their course and management, patients are at risk of a variety of complications involving various organ systems. This study focuses on the neurologic manifestations. The neurological presentation are either because of primary or secondary effects of malignancy or side effects of  treatments. These complications can occur in brain parenchyma, meninges, spinal cord, peripheral nerves and neuromuscular junction.Materials & methods: This was an analytical, retrospective, study of  patients with immuno-phenotypically confirmed leukemia & lymphomas who got referred for neurological complications were reviewed for neurological signs, symptoms, CSF, neuroimaging, treatment, and progress.Results & discussion: 67 patients with hematopoetic malignancy presented with neurological manifestations. Mean duration of presentation since diagnosis of malignancy was 7 months.  31/67 had  encephalopathy , 30/67 had seizures. 14/67 had paraparesis and 10/67 had stroke. Neurological  manifestations were categorized according to etiology , A-  disease related ( CNS leukemia, Thrombocytopenia, hyperleukocytosis) , B- chemotherapy related ,  C-manifestations secondary to infections ( Viral, CNS tuberculosis or fungal).Methotrexate was the most common culprit in chemotherapy related complications.  In disease related manifestations, 14/67  had CNS leukemia & 8/67  had manifestations of hyperleukocytosis / thrombocytopenia . Viral meningoencephalitis was most prevalent during treatment. Outcome analysis showed no residual morbidity in 43.3%, 34% with residual morbidity, 18% deaths. Conclusion :  With the help of this study, we could delineate  pattern of presentation of neurological complications along with its  temporal relationship helping in etiological diagnosis and  management of these patients.

 


Keywords


Haematological malignancies, neurological complications

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