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Nervous System Disturbances


This section has been reviewed and approved by the PLWC Editorial Board, 02/05

The nervous system is made up of the central nervous system (CNS) and the peripheral nervous system (PNS). The CNS is made up of the brain and spinal cord. The PNS is made up of the nerves outside of the CNS that carry information back and forth between the body and the brain. The PNS is involved in movement, sensing (touching, hearing, seeing, tasting, and smelling), and functioning of the internal organs, (for example, the stomach, lungs, and heart).

Nervous system disturbances are common side effects of cancer and cancer treatments and can affect any part of the nervous system. This article will outline nervous system disturbances, possible causes, and management. For information on cognitive problems related to cancer and cancer treatments, read Managing Side Effects: Cognitive Problems.

Types of nervous system disturbances

Some of the different types of nervous system disturbances that may result from cancer or cancer treatment include the following:

  • Hearing loss and/or tinnitus (ringing in the ears
  • Vision loss and/or vision disturbances (such as blurred or double vision)
  • Speech difficulties, such as slurred speech
  • Changes in taste and smell
  • Problems with balance, dizziness, vertigo (feeling like the room is spinning), and nausea
  • Problems with coordination (known as ataxia) and movement, including problems with posture, walking, or holding objects; clumsiness
  • Generalized weakness (known as asthenia), characterized by an overall lack of bodily strength; drowsiness
  • Paralysis of different parts of the body, ranging from paralysis of one side of the body (known as hemiplegia) to paralysis of a smaller area, such as the facial muscles
  • Seizures
  • Changes in the functioning of organs, resulting in symptoms, such as constipation, incontinence (inability to control bodily elimination), and erectile dysfunction (also called impotence or an inability to achieve or maintain an erection)
  • Pain, resulting from damage to the nerves
  • Peripheral neuropathy, a condition caused by damage or irritation to the peripheral nerves causing symptoms, such as numbness, tingling ("pins and needles"), or burning pain in the arms, hands, legs, or feet; decreased ability to sense hot and cold; difficulty lifting the feet or toes; difficulty picking up small objects; decreased muscle strength; vision or hearing changes; and/or constipation

Causes

Nervous system disturbances can be caused by many different factors, including cancer, cancer treatments, medications, or other disorders. Symptoms that are caused by disruption or damage to the nerves caused by cancer treatment (such as surgery, radiation treatment, or chemotherapy) can appear soon after treatment or many years later. Possible causes include the following:

  • Cancers that affect the nervous system, such as brain cancer and sarcomas of the nerves (for example, neurofibrosarcoma, malignant peripheral nerve sheath tumor, peripheral primitive neuroectodermal tumor)
  • Cancerous tumors growing in other parts of the body that press on nerves
  • Cancers that metastasize (spread) to the brain
  • Chemotherapy medications, such as vincristine (Oncovin), vinblastine (Velban), paclitaxel (Taxol), cisplatin (Platinol), carboplatin (Paraplatin), oxaliplatin (Eloxatin), fluorouracil (5-FU), cytarabine (Ara-C)
  • Radiation treatment, especially to the head and neck or total body irradiation
  • Surgery—nerves may be damaged or disrupted during surgery to remove cancerous tumors or perform biopsies
  • Medications, including some antinausea drugs, antibiotics, heart medications, diuretics, and nonsteroidal anti-inflammatory drugs
  • Infections causing swelling or inflammation of the brain, spinal cord, or inner ear
  • Other conditions or symptoms related to cancer or cancer treatments, including anemia, dehydration, fatigue, stress, and depression
  • Other conditions or disorders not related to cancer, such as diabetes, multiple sclerosis, and nerve injury

Management

Nervous system disturbances can be very distressing for patients and, in serious cases, can make it difficult for patients to complete normal, daily activities. Some symptoms caused by cancer treatment will resolve after treatment ends, but some may continue indefinitely. Although nerve damage and nervous system disturbances may not be preventable, most are effectively treated if diagnosed early. Early treatment can also prevent symptoms from becoming more problematic. It is important to tell your doctor immediately if you experience any symptoms that could indicate a nervous system disturbance. Once diagnosed, management of nervous system disturbances may include the following:

  • Medications, such as antinausea/antivertigo drugs (for example, meclizine [Antivert, Bonine], prochlorperazine [Compazine], scopolamine patch [Transderm-Scop], antibiotics, and corticosteroids (to reduce inflammation and swelling)
  • Pain medications, including opioid (strong) pain killers, as well as tricyclic antidepressants (for example, nortriptyline [Pamelor, Aventyl], amitriptyline [Elavil, Endep]) and/or seizure medications (for example, gabapentin [Neurotonin]) used to treat peripheral neuropathy and other types of nerve pain (known as neuropathic pain)
  • Nerve blocks and transcutaneous electric nerve stimulation (TENS), which provide pain relief
  • Occupational therapy, to enhance motor skills needed for daily activities, such as getting dressed, picking up small objects, writing, or doing household chores
  • Physical therapy, to enhance physical strength, balance, coordination, and mobility
  • Changes to the home environment to increase safety, such as installing hand rails in the bathroom, using nonskid rugs, adding extra lighting, and checking water temperature with the elbow rather than the hands

More Information

PLWC: Managing Side Effects

Cancersymptoms.org: Peripheral Neuropathy

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