Neurological complications of steroids and of supportive care

Corticosteroids are commonly employed within oncology primarily as either part of a direct treatment regimen or more broadly a supportive care modality. However, despite the widespread and well-established benefits of corticosteroids in these roles, a myriad of side effects can develop in correlation with the chronicity and/or dosage required in use. In particular, neurological side effects can be pronounced, leading to a limitation in their cumulative use and a concern for the potential significant impact on patient quality of life. Neurologic complications also arise during the care of patients with cancer as a direct consequence of additional supportive care medications, including antiepileptics, analgesics, antiemetics, and antidepressants in particular, or during the management of tumor-associated CNS vascular damage, including ischemic infarction or hemorrhagic injury. Here, we review the spectrum of corticosteroid-induced neurologic complications as well as the neurologic complications that arise secondary to supportive care measures of patients within oncology.