Neurologic complications of leukemia

In any patient with leukemia and new neurologic findings, the first entity that must be considered is direct invasion of the nervous system. If that is not a consideration, one must systematically consider cerebrovascular disorders, CNS infections, or metabolic abnormalities as the cause. Finally, one must not overlook radiotoxicity, chemotoxicity, or both in the differential diagnosis. Although some neurologic disorders are stereotyped in their presentation and are relatively easy to recognize, others continue to perplex the physician. Symptoms may be multifactorial in origin, compounding the problem. Leukemia is a systemic disease that may affect the nervous system at any site and at any time during the illness. Now that cure is possible and even to be expected in these diseases, it has become even more important to recognize and alleviate any neurologic morbidity.