Neurological Disorders Associated with Malignant Disease.

CEREBRAL metastases occur in approximately 5% of all fatal cases of malignant disease (Willis, I952) and the effects of discrete macroscopical deposits are well known. On the other hand, disorders of the nervous system resulting from either diffuse microscopical infiltration or other associated changes are less familiar and are the main concern of this survey. In recent years it has been shown that carcinoma is sometimes associated with neuromuscular lesions which are not due to metastases. The resultant disorders are commonly termed carcinomatous neuropathy, myopathy or neuromyopathy, according to the site of the lesion. Although the adjective carcinomatous is also applicable to other neurological complications of carcinoma, such as those due to metastases, the term carcinomatous neuropathy is used in this paper with its current arbitrary non-metastatic connotation. Diffuse carcinomatous infiltration of the brain, nerve roots or meninges may' produce a clinical picture which resembles carcinomatous neuropathy; this can only be established microscopically and precise diagnosis may therefore depend on pathological examination. Furthermore, neurological complications occasionally result from carcinoma emboli, from an associated thrombotic syndrome or from induced dietary or metabolic defects. Neurological lesions which are not due to gross metastases and sometimes complicate the diseases broadly classified as malignant reticuloses have also been described recently and merit consideration.