Neurological Toxicity Recognition: ICANS Assessment and Management
Panelists discuss how the assessment and management of immune effector cell–associated neurotoxicity syndrome involves grading symptoms from mild to life-threatening, emphasizing the need for prompt recognition and rapid intervention to prevent progression and minimize long-term neurological damage.
Summary for Physicians:
Neurological Toxicity: Immune Effector Cell–Associated Neurotoxicity Syndrome (ICANS) Assessment and Management
- ICANS (Immune-Related Neurotoxicity):
- Can range from mild symptoms (eg, confusion, agitation) to severe effects (eg, encephalopathy, seizures).
- Assessment includes evaluating mental status, motor function, speech, and level of consciousness.
- Grading ICANS:
- Grade 1: Mild symptoms, no intervention needed
- Grade 2: Moderate symptoms, requires intervention (eg, corticosteroids)
- Grade 3: Severe symptoms, may need intensive care unit admission and aggressive treatment
- Grade 4: Life-threatening symptoms, requires urgent intervention
- Management:
- Mild (grade 1): Supportive care, close monitoring
- Moderate to severe (grade 2-4):
- Administer steroids (eg, dexamethasone) to manage inflammation.
- For grade 3/4, consider immunosuppressive therapy and intensive neurological monitoring.
- Prompt recognition is critical for preventing progression.
Challenges:
Early detection and rapid intervention are key to minimizing long-term neurological impact.
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