[Neurological side-effects associated with immune checkpoint inhibitors].

Abstract

The use of checkpoint inhibitors has shown significant clinical benefit in various cancer types but also carries a risk of immune-related adverse events (irAEs). As the use of checkpoint inhibitors continues to rise, so does the incidence of irAEs. Among these, neurological adverse events (neuro-irAEs) are particularly challenging to detect since they can manifest with a wide range of symptoms, often mimicking disease progression. In addition, neuro-irAEs may follow a severe clinical course, potentially leading to life-threatening consequences if not recognized promptly. We present three cases illustrating the variety in symptoms and signs related to neuro-irAEs including muscle weakness, sensory disturbances, intermittent seizures and double vision. In each scenario, the probable diagnosis of a neuro-irAE posed a significant challenge, necessitating the exclusion of alternative causes. This emphasizes the need for awareness among healthcare professionals regarding neuro-irAEs in the era of expanding checkpoint inhibitor use.