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What is Leptomeningeal Disease (LMD) (lep-toe-men-in-gee-al disease)

Often referred to as carcinomatous meningitis, leptomeningeal disease (LMD) occurs when cancer is disseminated throughout the spinal fluid. It is caused by the spread of either primary or metastatic disease to the leptomeningeal space, which serves as a reservoir for cerebrospinal fluid. It is thought to occur in 3-5% of all cancer patients. Melanomas or cancers which originate in the breast or lung are the most likely to transform into LMD. Tumor cells may coat the cranial nerves or the cauda equina, causing cranial nerve deficit or radiculopathy (a condition where one or more nerves don't work properly causing pain, weakness, numbness, etc). For more information about leptomeningeal disease, or to schedule an appointment, call (407) 303-1700 or click here to fill out an online assistance form.

Doctors at the Florida Hospital Brain and Spinal Cancer Program work together to develop a treatment plan which also treat the primary cancer tumor and provide the best outcome for patients with LMD. Patients with LMD may also have the opportunity to participate in clinical trials. 

Causes of Leptomeningeal Disease (LMD)

Leptomeningeal disease occurs when tumor cells infiltrate the cerebrospinal fluid pathways and travel various parts of the brain and spinal cord and begin to grow. Even though this disease is often assumed to be fatal, patients at Florida Hospital Cancer Institute have benefited greatly from a combination of surgery, radiation, and chemotherapy. 

For more information about leptomeningeal disease, or to schedule an appointment, call (407) 303-1700 or click here to fill out an online assistance form.

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Symptoms of Leptomeningeal Disease (LMD)

General signs and symptoms of leptomeningeal disease include those associated with brain pressure. These may include headaches, changes in mental status, nausea and vomiting, difficulty with balance, seizures, and papilledema. Cranial nerve symptoms including visual loss, diplopia, hearing loss, dysphagia, ocular muscle weakness, facial weakness, and facial pain are also seen. For patients with spinal LMD, radicular pain, weakness, and paresthesias are also common.

For more information about leptomeningeal disease, or to schedule an appointment, call (407) 303-1700 or click here to fill out an online assistance form.

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Tests to Diagnose Leptomeningeal Disease (LMD)

In order to diagnose leptomeningeal disease, physicians at Florida Hospital Cancer Institute may recommend a variety of tests and scans. These may include the following:

  • A physical exam and medical history: Your physician will check your general signs of health, including signs of disease, such as lumps or anything that seems out of the ordinary. Your medical history including your health habits and past illnesses and treatments will also be checked.
  • A neurological exam: You will be asked to answer a series of questions and perform simple tests in order to check your brain, spinal cord and nerve function. These exams will check your mental status, coordination, and ability to walk normally (along with muscles, senses and reflexes).
  • An MRI (magnetic resonance imaging): During the MRI procedure, a magnet, radio waves and a computer will be used to make a series of pictures of your brain and spinal cord.

For more information about leptomeningeal disease, or to schedule an appointment, call (407) 303-1700 or click here to fill out an online assistance form.

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Treatment for Leptomeningeal Disease (LMD)

The most common treatment for leptomeningeal disease is chemotherapy

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