Neurological consultation in the management of patients with systemic cancer admitted to a community hospital.

Abstract

To characterize the neurological complications of cancer patients admitted to a community hospital, the charts of all cancer patients evaluated by a neurologist during a single year were reviewed. Nine percent (N = 93) of cancer patients received neurological consultation compared to 3.6% of other patients. The neurologic problem preceded the diagnosis of cancer in 11% of patients. Complications were most common with known metastases. Neurologists frequently discovered signs not noted by the referring physician: 52 patients were paretic, with weakness reported in only 31; cranial nerve complaints were described in 3, but found in 20; sensory abnormalities were noted in 8, but found in 26. A change in mental status was confirmed in 33% and ataxia in 10%. After consultation, distant metastasis was diagnosed in 40% of patients, direct extension in 8%, metabolic encephalopathy in 14% and remote effects of cancer and side effects of cancer therapy in 4% each. Other patients had unrelated diagnoses. In most cases, the neurologic consultation let to a change in treatment, with radiotherapy directed to a symptomatic tumor mass the most common beneficial outcome.

• Authors: R K Portenoy, L Krupp, R Kanner
• Journal: Cancer investigation (Cancer Invest) Vol. 4 Issue 4 Pg. 293-6 ( 1986) ISSN: 0735-7907 [Print] England
• PMID: 3768759 (Publication Type: Journal Article)

Topics

• Hospitals, Community
• Humans
• Neoplasm Metastasis (diagnosis)
• Neoplasms (physiopathology)
• Nervous System Diseases (diagnosis)
• Referral and Consultation