. Author manuscript; available in PMC: 2016 Aug 10.

Published in final edited form as: Nat Rev Clin Oncol. 2015 Sep 22;13(2):92–105. doi: 10.1038/nrclinonc.2015.152

Table 3.

Cranial Neuropathies

Symptom	Causes	Notes
Anosmia	Any chemotherapy RT	Dysgeusia
Visual Loss	Carmustine Cisplatin Cytarabine Fludarabine Oxaliplatin Tamoxifen Bevacizumab RT	Intra-arterial administration Reversible Retinal deposits Optic neuropathy Dry eye syndrome, cataract, glaucoma, retinopathy, optic neuropathy (begins 7–26 months after RT, painless, monocular or bilateral blindness, papilledema and retinal hemorrhage may be present)
Extraocular Palsy	Cytarabine Vincristine Interferon-α
Ptosis	Vincristine
Facial Weakness	Vincristine Vemurafenib	Isolated case reports of peripheral facial nerve palsy, sometimes bilateral
Hearing Loss	Carmustine Cisplatin Vincristine Oxaliplatin RT (to head or ear)	Intra-arterial administration Hair cell damage⁷⁰, usually doses greater than 60 mg/m², typically irreversible. Possible prophylactic treatments include amifostine, vitamin E⁷¹, sodium thiosulfate, and intratympanic steroids, but there is limited evidence to support their use. RT-induced otitis media causes conductive hearing loss, perhaps requiring myringotomy. RT-induced endarteritis produces vascular damage within the cochlea or CNVIII that causes late delayed sensorineural hearing loss
Vestibular Dysfunction	Cisplatin
Hoarseness	Cytarabine Vincristine Bevacizumab
Dysarthria	Irinotecan Methotrexate	Usually transient, but can occur with subsequent infusions
Bulbar dysfunction	Cytarabine RT (to the neck)	Late delayed effect (over 10 years), myokymia on electromyography, may involve recurrent laryngeal, vagal, hypoglossal nerves as well as sympathetic fibers
Jaw tightening	Oxaliplatin Vincristine	Jaw pain