Diagnosis and Management of Neurological Immune Related Adverse Events

As the use of immune checkpoint inhibitors (ICIs) continues to rise, particularly in combination therapies, neurological immune-related adverse events (irAEs) are expected to become more prevalent in clinical practice. These neurological irAEs are rare but often present with atypical and multifocal manifestations, potentially leading to severe neurological impairments or even mortality. Treatment generally involves discontinuation of ICIs, along with corticosteroids, intravenous immunoglobulin, and/or plasma exchange. Effective management requires early diagnosis and a multidisciplinary approach. To this end, a comprehensive understanding of neurological irAEs by clinicians is essential, and this review describes key considerations for the accurate diagnosis and treatment of neurological irAEs.