Neoplastic meningitis medical therapy: Difference between revisions
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*[[Anticonvulsants]]: administered to the patients who have a [[seizure]]. | *[[Anticonvulsants]]: administered to the patients who have a [[seizure]]. | ||
*[[Corticosteroids]]: usually [[dexamethasone]], given 4-10 mg every 4-6 h, can reduce peritumoral [[edema]] and lower intracranial pressure with a decrease in symptoms ([[headache]] or [[drowsiness]]). | *[[Corticosteroids]]: usually [[dexamethasone]], given 4-10 mg every 4-6 h, can reduce peritumoral [[edema]] and lower intracranial pressure with a decrease in symptoms ([[headache]] or [[drowsiness]]). | ||
*[[Opiates]]: pain medication | |||
==References== | ==References== | ||
Revision as of 22:19, 22 January 2016
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Neoplastic meningitis Microchapters |
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Neoplastic meningitis medical therapy On the Web |
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American Roentgen Ray Society Images of Neoplastic meningitis medical therapy |
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Risk calculators and risk factors for Neoplastic meningitis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Overview
The mainstay of therapy for neoplastic meningitis is intrathecal chemotherapy.[1]
Medical Therapy
The various treatment options for neoplastic meningitis include:[1]
Treatment of neoplastic meningitis | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Intrathecal chemotherapy | Radiotherapy | Surgery | Supportive care | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Chemotherapy
- The mainstay of therapy for neoplastic meningitis is intrathecal chemotherapy.[1]
- Chemotherapy can help in treatment of the total involved neuraxis. It may be administered systemically or intrathecally.
- Chemotherapy given via systemic route has poor CSF penetration, hence intrathecal chemotherapy is the preferred mode of administration.
- Chemotherapeutic drugs can be given intrathecally either by lumbar puncture or via an intraventricular reservoir system.
- Accessing via the intraventricular reservoir system is preferred to lumbar puncture for the following reasons:[1]
- Simple procedure
- More comfortable for the patient
- Safer than repeated lumbar punctures
- Better uniform distribution of the drug in the subarachnoid space
- Chemotherapeutic agents that are routinely used include:[1]
Radiotherapy
Supportive Care
Supportive care should be directed towards all patients with neoplastic meningitis, regardless of the treatment regimen.
- Anticonvulsants: administered to the patients who have a seizure.
- Corticosteroids: usually dexamethasone, given 4-10 mg every 4-6 h, can reduce peritumoral edema and lower intracranial pressure with a decrease in symptoms (headache or drowsiness).
- Opiates: pain medication