Neurotoxicity problems during chemotherapy


Neurotoxicity

One must understand the nervous system, the agents related to neurologic symptoms, and also the presenting indications of neurologic syndromes to identify chemotherapy-induced neurotoxicity. The nervous system regulates and maintains body function through stimuli reception and response.

The constituents of the nervous system would be the peripheral nervous system, the central nervous system, and also the autonomic nervous system. Toxicity affecting these different components has separate symptoms. Toxicity towards the peripheral nervous system, which comprises the sensory and motor nerves, results in paresthesias, numbness, and tingling of the feet and hands.

The CNS, composed of the brain and spinal-cord, accounts for the neurologic functions of mental status, degree of consciousness, sensory and motor functions, cerebellar function, and cranial nerve function. The toxic manifestations are confusion, dizziness, and unsteady gait. Toxicity towards the autonomic nervous system results in constipation, urinary retention, impotence, and postural hypotension.

Another component of the nervous system that is essential to understand may be the blood-brain barrier. The blood-brain barrier determines whether a cytotoxic agent can get to the nervous system. It blocks some agents from entering the system in a cellular level.

Penetration of the CNS differs from that of the peripheral nervous system. Subsequently, the chemotherapeutic agents that can penetrate towards the peripheral nervous system cause neurologic changes involving sensation and pain, whereas agents that can penetrate the blood-brain barrier towards the CNS cause alterations in cranial nerve, mental, cerebellar, motor, and sensory function.

The assorted factors recognized to cause neurologic symptoms in oncology patients, combined with neurotoxic results of many antineoplastic agents, often make it hard to discern the reason for chemotherapy-induced neurotoxicity. The danger factors speculated to predispose patients receiving potentially neurotoxic agents to toxicity are:

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