Some chemotherapy drugs can cause direct or indirect changes in the central nervous system (brain and spinal cord), the cranial nerves, or peripheral nerves. The cranial nerves are connected directly to the brain and are important for movement and touch sensation (feeling) of the head, face, and neck. Cranial nerves are also important for vision, hearing, taste, and smell. Peripheral nerves lead to and from the rest of the body and are important in movement, touch sensation, and regulating activities of some internal organs.
Side effects that are the result of nerve damage (or neuropathy) caused by chemotherapy can occur soon after chemotherapy starts or even years later.
Changes in the central nervous system could produce these symptoms:
- Stiff neck
- Headache
- Nausea and vomiting
- Lethargy or sleepiness
- Fever
- Confusion
- Depression
- Seizures
Damage to the cranial nerves may cause these symptoms:
- Visual problems (such as blurred vision or double vision)
- Increased sensitivity to odors
- Hearing loss or ringing in the ears
- Dry mouth
Peripheral nervous system changes (often called peripheral neuropathy) usually affect the hands and feet and can include:
- Numbness
- Tingling (“pins and needles”)
- Decreased sensation
- Pain
Peripheral nervous system changes may make you feel clumsy and cause difficulty in daily activities such as opening jars, fastening buttons, or squeezing toothpaste tubes. You can get more information on this in our document called Peripheral Neuropathy Caused by Chemotherapy.
Some of the most commonly used drugs that cause peripheral nerve damage include the mitotic inhibitors (vincristine, paclitaxel, docetaxel, etc.) and cisplatin.
Nerves can heal, and if the chemotherapy dose is lowered or treatment is stopped, the symptoms will usually decrease or disappear. However, in some people the damage may be permanent. For this reason it is important that you report any changes to your healthcare team as soon as possible.
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