Three patients with CNS disorders under the treatments withimmune checkpoint inhibitors

Abstract

We described three patients with central nervous system（CNS）disorders associated with the treatment　with immune checkpoint inhibitor（ICI）. A patient with myelitis showed mild improvement in neurological　features and reduction in abnormal intraspinal highintensities on MRI after both the discontinuation of ICI and　treatment with steroids. Second patient with encephalitis was underwent the treatment with steroids in　addition to withdrawal of ICI, and his consciousness became clear with disappearing cranial abnormal　highintensities on MRI. In third patient, asymptomatic hypertrophic pachymeningitis spontaneously　disappeared after stopping ICI only. When we encounter a patient with CNS disorders associated with ICI,　firstly ICI should be discontinued and additional immunological treatments such as steroids were recommend,　especially in patients whose CNS features were deteriorated or those with myelitis.