Expanding use of immune‐checkpoint inhibitors (ICIs) underscores the importance of accurate diagnosis and timely management of neurological immune‐related adverse events (irAE‐N). We evaluate the real‐world frequency, phenotypes, co‐occurring immune‐related adverse events (irAEs), and long‐term outcomes of severe, grade III to V irAE‐N at a tertiary care center over 6 years. We analyze how our experience supports published literature and professional society guidelines. We also discuss these data with regard to common clinical scenarios, such as combination therapy, ICI rechallenge and risk of relapse of irAE‐N, and corticosteroid taper, which are not specifically addressed by current guidelines and/or have limited data. Recommendations for management and future irAE‐N reporting are outlined. ANN NEUROL 2020;87:659–669

中文翻译：

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免疫检查点抑制剂的严重神经毒性：不断扩大的范围

免疫检查点抑制剂 (ICI) 的扩大使用强调了准确诊断和及时管理神经免疫相关不良事件 (irAE-N) 的重要性。我们评估了三级医疗中心 6 年内在现实世界中发生的频率、表型、同时发生的免疫相关不良事件 (irAE) 和严重的 III 至 V 级 irAE-N 的长期结果。我们分析了我们的经验如何支持已发表的文献和专业协会指南。我们还讨论了关于常见临床情况的这些数据，例如联合治疗、ICI 再激发和 irAE-N 复发的风险，以及皮质类固醇减量，目前的指南没有具体解决这些问题和/或数据有限。概述了管理和未来 irAE-N 报告的建议。神经网络 2020;87:659–669