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Patients with malignant meningitis presenting with neuropsychiatric manifestations
Author(s) -
Weitzner Michael A.,
Olofsson Shatha M.,
Forman Arthur D.
Publication year - 1995
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19951115)76:10<1804::aid-cncr2820761019>3.0.co;2-7
Subject(s) - medicine , meningitis , delirium , differential diagnosis , complication , presentation (obstetrics) , cancer , pediatrics , cerebrospinal fluid , intensive care medicine , surgery , pathology
Background . Malignant meningitis is often thought of as a late event in the course of cancer. At one time, it was thought to be rare, but it has been recognized more frequently in recent times. Clinical suspicion of malignant meningitis is prompted by neurologic symptoms and signs in patients at risk for this oncologic complication. Neuropsychiatric symptoms previously were not considered as presenting symptoms of malignant meningitis. Methods . Three patients with cancer with no neurologic symptoms were examined for malignant meningitis based on neuropsychiatric symptoms. Cerebrospinal fluid was examined for malignant cells to confirm the diagnosis of malignant meningitis. Results . The clinical presentation of malignant meningitis for three patients was neuropsychiatric. None of the patients had delirium during their initial presentation. Conclusions . It is important that clinicians recognize that psychiatric symptoms without neurologic findings may indicate malignant meningitis and that malignant meningitis needs to be included in the differential diagnosis of neuropsychiatric disorders in patients with cancer. Cancer 1995; 76:1804‐8.