Neuromuscular symptoms in cancer patients

The neuromuscular system is often affected in patients with cancer. This can be due to a direct effect of cancer, neurotoxic treatment, radiation therapy or paraneoplastic phenomena. This review focuses on the sites of involvement, such as cranial nerves, nerve roots, and plexus, mono- and polyneuropathies disorders at neuromuscular transmission, and muscle disease. At each site of the peripheral nervous system, the most common types of involvement and therapeutic issues are discussed. Knowledge of neuromuscular symptoms is important for medical oncologists, neurologists and neuro-oncologist alike, as precise diagnosis may have therapeutic consequences for the patients. Immunologic therapies, or in some cases anticancer treatment may decrease the individual's burden of disease in paraneoplastic syndromes. Conventional cancer therapies, such as chemotherapy and radiation therapy, also have neurotoxic side effects which need to be outweighed against their therapeutic effect. Several other less well-defined complications such as infection, hemorrhage or metabolic disorders have to be considered as a differential diagnosis. Complications of surgical and other interventions will not be discussed in this context.