Cognitive Impairment After Chemotherapy (Chemo Fog, Chemo Brain)

 

Drugs affecting cognition include:

(1) cisplatin

(2) cytosine arabinoside

(3) carmustine

(4) methotrexate

(5) 5-fluorouracil

 

Manifestations:

(1) forgetfulness, loss of memory, difficulty recalling names, facts or figures

(2) loss of concentration or difficulty focusing or lack of mental sharpness ("foggy")

(3) impaired executive functions

(4) easy distractibility

 

The manifestations may range from subtle to full-blown dementia. For some patients the changes are reversible with time while others may progress.

 

Differential diagnosis:

(1) radiation to the brain

(2) brain metastasis

(3) pre-existing dementia (Alzheimer's disease, HIV-related, etc)

(4) electrolyte abnormality

(5) cognitive impairment due to other drugs

(6) delirium

(7) depression