Neurological Exam

Some cancers and cancer treatments can cause neurological changes (changes to how your brain and spinal cord work). A neurological exam, sometimes called a neuro exam, can be done to test your baseline results and if you are having any neurological changes.

What is a neurological exam?

A neurological exam is a series of tests that can help check how your brain is working. You may be asked questions that check your memory, skills that test your balance, strength, and reflexes, and tests that check that your nerves are working correctly.

Why might I have a neurological exam?

A baseline neurological exam might be done when you are first diagnosed with cancer. It helps you and your care team to see if there are any changes to your brain during and after your treatment. For example, a baseline neurological exam might be done before you have chemotherapy treatment and throughout treatment to see if you have any changes.

Neurological changes can be short-term or lifelong. Whether you have testing depends on:

• Your type of cancer.
• The treatments you had or are going to have.
• Your age.
• Whether you have had neurological issues in the past.
• The healthcare center where you are being treated.
• If you, a caregiver, or a family member has noticed neurological changes in you.

How is a neurological exam done?

First, your provider will do a physical exam and review your health history. Neurological changes can affect your memory, alertness, muscle strength, balance, and vision, so your provider might test one or all of these. Your provider might use a reflex hammer to check your reflexes. Several cranial nerves in your brain help you hear, swallow, smell, taste, move your tongue, and shrug your shoulders. Your provider might test these to see if certain nerves are being affected. Neurological exams might be done more than once during your treatment. If neurological testing shows abnormal findings, your provider will likely have you do an MRI and/or CT scan.

What can cause neurological changes?

Many things can cause neurological changes. Some of these are:

• Cancer itself. For example, a brain tumor can be putting pressure on your brain and can change how your brain is working.
• Treatments for cancer like chemotherapy, radiation, and some medications.
• Changes in how your organs are working (liver, kidney, brain, thyroid) and not having enough of certain vitamins in your body.
• Age.
• Dehydration.
• Infection.

What are neurological changes to look out for?

Some things that you should look out for and tell your provider about are:

• Cognitive changes, or changes in how you think or process, like trouble with memory, multitasking, organization, making plans or decisions, and learning new things.
• Issues with moving, like trouble walking, losing your balance, or falling.
• Changes in your vision, hearing, swallowing, and taste.
• Changes in how you feel pain and temperature.
• Dizziness, weakness, or uncontrollable movements of a part of your body.
• Any new or worsening change in your health or how you are feeling.  

Talk to your provider if you are having any neurological issues before, during, and after your cancer treatment. This will help your provider choose what type of testing and treatment would be best for you.