Table 3. Central Nervous System Late Effects
| Predisposing Therapy | Neurologic Effects | Health Screening |
| IQ = intelligence quotient; IT = intrathecal; IV = intravenous. | ||
| Platinum agents (carboplatin, cisplatin) | Peripheral sensory neuropathy | Neurologic exam |
| Plant alkaloid agents (vinblastine, vincristine) | Peripheral sensory or motor neuropathy (areflexia, weakness, foot drop, paresthesias) | Neurologic exam |
| Methotrexate (high dose IV or IT); cytarabine (high dose IV or IT); radiation impacting the brain | Clinical leukoencephalopathy (spasticity, ataxia, dysarthria, dysphagia, hemiparesis, seizures); headaches; seizures; sensory deficits | History: cognitive, motor, and/or sensory deficits, seizures |
| Neurologic exam | ||
| Radiation impacting cerebrovascular structures | Cerebrovascular complications (stroke, moyamoya, occlusive cerebral vasculopathy) | History: transient/permanent neurological events |
| Blood pressure | ||
| Neurologic exam | ||
| Neurosurgery–brain | Motor and/or sensory deficits (paralysis, movement disorders, ataxia, eye problems [ocular nerve palsy, gaze paresis, nystagmus, papilledema, optic atrophy]); seizures | Neurologic exam |
| Neurology evaluation | ||
| Neurosurgery–brain | Hydrocephalus; shunt malfunction | Abdominal x-ray |
| Neurosurgery evaluation | ||
| Neurosurgery–spine | Neurogenic bladder; urinary incontinence | History: hematuria, urinary urgency/frequency, urinary incontinence/retention, dysuria, nocturia, abnormal urinary stream |
| Neurosurgery–spine | Neurogenic bowel; fecal incontinence | History: chronic constipation, fecal soiling |
| Rectal exam | ||
| Predisposing Therapy | Neuropsychological Effects | Health Screening |
| Methotrexate (high-dose IV or IT); cytarabine (high-dose IV or IT); radiation impacting the brain; neurosurgery–brain | Neurocognitive deficits (executive function, memory, attention, processing speed, etc.); learning deficits; diminished IQ; behavioral change | Assessment of educational and vocational progress |
| Formal neuropsychological evaluation | ||
