By David Schiff, Santosh Kesari, Patrick C. Y. Wen
Neuro-oncology has developed considerably as a scientific and study self-discipline over the last few a long time. Cancer Neurology in scientific perform: Neurologic problems of melanoma and its therapy, moment Edition presents clinicians from numerous backgrounds and degrees of teaching with a connection with aid concentration the differential analysis, remedy procedure, and administration plan for the melanoma sufferer with neurologic signs and findings.
The quantity starts with an outline of the sphere of neuro-oncology and a assessment of the position of neuroimaging within the prognosis of neuro-oncologic affliction. numerous chapters on interpretation and administration of universal neuro-oncologic indicators persist with. next sections include chapters at the direct and oblique neurologic issues of melanoma in addition to problems of remedy. the ultimate part makes a speciality of the spectrum and administration of neurologic ailment in sufferers with melanoma of particular organs.
Cancer Neurology in scientific perform: Neurologic problems of melanoma and its remedy, moment Edition is a crucial new paintings that goals to expand and deepen the familiarity of clinicians with the diversity and administration of neuro-oncologic illnesses that allows you to enhance the standard of take care of melanoma patients.
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Additional info for Cancer Neurology in Clinical Practice; Neurologic Complications of Cancer and Its Treatment
Most clinical whole–body FDG PET studies performed in cancer patients specifically exclude the brain from the images. Newer tracers are continuously being developed for PET imaging, which may further increase the utility of this modality in evaluation of brain metastases. 4. Approach to Evaluation of Patients with Newly Diagnosed Brain Masses The diagnostic approach to patients with a newly detected brain mass has recently been critically evaluated. Patients present to their physician’s office or to the emergency ward with neurologic symptoms and a brain mass is discovered on neuroimaging.
In patients with known cancer, an MRI scan with FLAIR images and contrast enhancement is the optimum neuroimaging test. Extensive studies to evaluate infectious, metabolic, and drug-related etiologies are also critical, and in many cases a cerebrospinal fluid examination is indicated. While surgical therapy of tumorassociated seizures holds promise, particularly for patients with low-grade primary brain tumors, intraoperative electrocorticography may be required for optimum seizure control, and post-operative anticonvulsant medication is usually necessary.
While the evidence remains inconclusive, some investigators have reported that the concurrent use of enzyme-inducing antiepileptic drugs and P450-metabolized chemotherapeutic agents may even decrease survival (105–107). Conversely, anticonvulsant levels are often reduced in the setting of concurrent chemotherapy despite seemingly adequate doses (108–117). In addition to P450-mediated interactions, antineoplastic agents may decrease anticonvulsant absorption by damaging 55% <5% 15–41% Potent Enzyme inhibitor No No Modest No Limited∗ Modest Modest Phenobarbital Valproic acid Gabapentin Pregabalin Lamotrigine Levetiracetam Topiramate Tiagabine Zonisamide 7-9 > 60 21 25 6-8 9–16 5–7 6 100 12–17 8–10** 22 Half-life (hours) * Induces catabolism of ethinyl estradiol but inhibits metabolism of phenytoin.