Chemotherapy and Targeted Therapy: Distinguishing Neurotoxicity From Paraneoplastic Syndromes

WATCH TIME: 6 minutes | Captions are auto-generated and may contain errors.

This clinical video series, titled “Crossroads in Neuro-Oncology: Understanding Paraneoplastic Neurologic Syndromes,” is a NeurologyLive^® Roundtable Discussion focused on the recognition and management of paraneoplastic neurologic syndromes (PNS) in patients with cancer. These immune mediated neurologic disorders can present across the cancer continuum and may cause rapid functional decline, underscoring the importance of early identification, appropriate diagnostic evaluation, and coordinated multidisciplinary care.

In collaboration with Northwestern Medicine, neuro-oncology experts Shailee Samir Shah, MD, clinical assistant professor of neurology, and Ditte Primdahl, MD, assistant professor of neurology, joined host Jax DiEugenio to provide a clinical overview of PNS. The discussion covered real-world presentation patterns, diagnostic considerations, screening protocols, and patient selection criteria. The experts also evaluate modern therapeutic interventions and practical management strategies while exploring the evolving treatment landscape for PNS.

In this fourth episode, Shah and Primdahl explored the diagnostic overlap between PNS and treatment-related neurotoxicity in patients receiving cytotoxic or targeted therapies. They discussed how cumulative exposure to systemic treatments can obscure or delay recognition of PNS, as well as which therapies most commonly complicate diagnosis. The pair then examined how treatment timing influences the evolution and potential reversibility of neurologic deficits and outlined how neuro-oncologists can guide decisions around dose modification or treatment interruption when neurologic symptoms emerge during active therapy.

Click here to watch more episodes of this video series.