Documentation of neurotoxicity resulting from high-dose cytosine arabinoside.

High-dose cytosine arabinoside or ARA-C (HDAC) has been shown to be an effective regimen in patients who are refractory to conventional doses. Neurotoxicity, a side effect associated with HDAC, has been reported in 7%-28% of patients. Both cerebellar and cerebral dysfunction have been reported. Neurotoxicity cannot be completely prevented, but a nurse's early detection of subtle changes can decrease toxicity severity. Assessment includes evaluating the patient's level of consciousness, speech patterns, vision, ocular movements, and coordination of upper and lower extremities. Early detection and intervention can lead to improved patient outcomes and enhanced quality of life. A neurotoxicity assessment tool and implications for its use are presented.