Neurologic Adverse Events from Immune Checkpoint Inhibitors

Immune checkpoint inhibitors (ICI) have revolutionized cancer treatment, but they can trigger a wide range of neurological immune-related adverse events (irAE) by disrupting immune tolerance. These complications affect both the central and peripheral nervous systems, often manifesting with rapid progression and significant risks of disability or death. A particularly critical condition highlighted is Triple M syndrome, which involves the life-threatening triad of myasthenia, myositis, and myocarditis. Diagnostic challenges arise because these events often present with atypical symptoms, necessitating a protocol of excluding other causes while confirming neuroinflammation through laboratory and radiological data. Because many of these neurological events are resistant to standard corticosteroids, there is a growing emphasis on early intervention with targeted biologics and immunomodulatory therapies. Future medical research aims to improve patient outcomes by identifying predictive biomarkers and refining risk stratification, particularly for vulnerable populations with pre-existing autoimmune conditions.