The symptoms of leptomeningeal disease (LMD) can be similar to those of brain metastasis but will largely depend on where the leptomeningeal metastasis is located. Symptoms that suggest cancer has spread to the leptomeninges include:
- Headaches (particularly new/persistent headaches)
- Facial numbness or weakness
- Difficulty with speech
- Difficulty chewing or swallowing
- Double vision
- Hearing changes
- Problems with memory and thinking
- Lack of coordination in the arms and legs
- Difficulty walking
- Weakness, numbness, or tingling in the limbs
- Loss of bladder or bowel control
While leptomeningeal metastases do not form solid masses, cancer cells can cluster and lodge into the areas around the brain and/or spinal cord.
When leptomeningeal metastasis is present in the fluid that surrounds the brain, patients will experience symptoms that can affect the function of the cranial nerves. These nerves allow a person to 1) see, smell, and hear; and to 2) move the muscles in the face, head, and neck. Therefore, LMD can also cause facial numbness or weakness, difficulty with speech, difficulty chewing or swallowing, double vision, hearing changes, dizziness, and/or seizures.
When leptomeningeal metastasis is present in the fluid that surrounds the spinal cord, patients may experience symptoms that affect the nerves that run the length of the spinal cord from the neck, to the thoracic/chest area, to the lower back, and to the tailbone. These spinal nerves control muscle movement, sensation, and functions of internal organs like the bladder and intestines.
Therefore, symptoms of LMD around the spinal cord may include a lack of coordination in the arms and legs, difficulty walking, weakness, numbness, or tingling in the limbs, and/or loss of bladder or bowel control.
Because the cerebrospinal fluid (CSF) is constantly circulating, leptomeningeal metastasis can be present around both the brain and spinal cord which can result in fluid build-up that increases the pressure in these areas and can cause headaches, nausea, or vomiting.