Neurotoxicity is damage to the central or peripheral nervous system that may occur from exposure to toxic substances.
Exposure to certain toxins, such as heavy metals, pollutants, or certain medications, may damage nerve cells. This can affect how the nervous system functions and cause a range of neurological symptoms.
Some immunotherapies can cause neurotoxicity and lead to a condition known as immune effector cell-associated neurotoxicity syndrome (ICANS).
This article looks at the symptoms, causes, diagnosis, and treatment of neurotoxicity, as well as the specific effects of ICANS.
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Neurotoxicity can occur due to exposure to neurotoxins, which are natural or manmade substances that harm the nervous system.
This may cause a range of neurological symptoms, which are symptoms relating to the nervous system. This includes the brain, spinal cord, and nerves throughout the body.
Neurotoxins can impair how the nervous system functions and may affect movement, behavior, and cognitive abilities.
Symptoms of neurotoxicity include dysfunction relating to the nervous system, such as:
- confusion
- poor concentration
- memory loss
- personality changes
- pain
- numbness
- loss of sensation
- muscle weakness
- loss of coordination
- difficulty with speech or communication
- paralysis
- involuntary muscle jerks or spasms
- seizures
- changes to levels of consciousness
- coma
Symptoms may develop immediately after exposure to a neurotoxin or they can develop over time. In rare cases, neurotoxicity is life threatening.
Exposure to toxic substances, either manmade or natural, may cause neurotoxicity. These include:
- heavy metals, such as lead or mercury
- certain foods or additives
- pesticides
- pollutants
- bacteria and viruses
- industrial products
- solvents and some cleaning products
- pharmaceutical products
Certain medications, such as some cancer treatments, may cause neurotoxicity. It can occur as a side effect of:
- chemotherapy
- radiation therapy
- certain drug therapies
A range of cancer treatments may cause neurotoxicity, including anti-angiogenic treatments and immunotherapy drugs, such as immune checkpoint inhibitors.
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To diagnose neurotoxicity, doctors may carry out a range of tests to check neurological function. These can include:
- motor function tests
- neuropathology tests to check for disorders of the nervous system, such as tissue samples
- cognitive testing, such as memory, learning, or language tests
- nerve conduction velocity tests, which measure the movement of electrical signals through a nerve to check nerve function
- imaging tests, such as MRI scans, and cerebrospinal fluid analysis
Treating neurotoxicity may depend on the underlying cause. If certain medical treatments, such as immunotherapy drugs, are causing neurotoxicity, corticosteroids may
Chelation therapy may also be a
Avoiding or protecting the body from neurotoxin exposure where possible may help prevent neurotoxicity. Preventive steps
- avoiding exposure to toxins where possible, including heavy metals, solvents, industrial products, and pollutants
- avoiding smoking or exposure to second-hand smoke
- maintaining a healthy lifestyle, with a balanced diet and regular exercise
- avoiding eating any food that neurotoxic substances may have contaminated
Early recognition of symptoms and prompt treatment may help to prevent neurotoxicity from progressing further and stop long-term damage.
If a person is using medication that has a risk of neurotoxicity, it is best to report any new symptoms to a doctor and make sure to follow up regularly for surveillance testing.
ICANS is a potential complication of certain immunotherapies, including CAR-T cell therapy. People with certain blood cancers, such as lymphoma, may receive CAR-T cell therapy.
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Symptoms of ICANS include:
- headache
- confusion
- difficulty finding words
- trouble paying attention
- seizures
- loss of consciousness
ICANS typically develops within 3 to 10 days of CAR-T cell therapy. With treatment, symptoms may resolve in 7 to 10 days, but some people may require longer treatment.
Can neurotoxicity be reversed?
The reversal of neurotoxicity may depend on the extent of damage, the onset of treatment, and the underlying cause.
Cases of ICANS are
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What is an example of a neurotoxin?
Neurotoxic substances can include:
- heavy metals
- certain cancer treatments, such as chemotherapy, radiation treatment, and immunotherapy drugs
- pathogens, such as bacteria and viruses
- pollutants
- solvents and industrial products
How long does it take for neurotoxicity to go away?
The duration of neurotoxicity may depend on the cause and treatment. A
Chelation therapy for neurotoxicity
Neurotoxicity is damage to the nervous system due to exposure to neurotoxic substances, such as certain medications and environmental toxins.
Prompt treatment may help to resolve and reverse neurotoxicity and prevent further damage. If people have any signs of neurotoxicity, they will need to seek medical attention as soon as possible.