RT Journal Article SR Electronic T1 Language dysfunction-associated EEG findings in patients with CAR-T related neurotoxicity JF BMJ Neurology Open JO BMJ Neurol Open FD BMJ Publishing Group Ltd SP e000054 DO 10.1136/bmjno-2020-000054 VO 2 IS 1 A1 Elisaveta Sokolov A1 Philipp Karschnia A1 Reuben Benjamin A1 Robert D M Hadden A1 Robert C D Elwes A1 Lee Drummond A1 Devyani Amin A1 Vitor Paiva A1 Alex Pennisi A1 Aline Herlopian A1 Matthew Frigault A1 Robin Sanderson A1 Shafqat Inam A1 Andrew J Cole A1 Jorg Dietrich YR 2020 UL http://neurologyopen.bmj.com/content/2/1/e000054.abstract AB Chimeric antigen receptor-modified T cells (CAR-T) have emerged as a promising immunotherapeutic approach in relapsed/refractory haematolgical malignancies. Broader application is limited by unique toxicities, notably, neurotoxicity (NTX). Language dysfunction is among the most frequent symptoms of NTX, the underlying mechanisms of which remain to be elucidated. Electroencephalogram (EEG) is an important tool to monitor for NTX and may provide insights into language dysfunction.Aim We aimed to characterise language dysfunction and define electroencephalographic signatures after CAR-T cell therapy.Methods We reviewed the clinical presentation and EEG findings of 20 adult patients presenting with language dysfunction after CAR-T cell infusion. The cohort included a subset of patients treated with investigational CD19-directed CAR-T cells for non-Hodgkin’s lymphoma (n=17), acute lymphoblastic leukaemia (n=1), follicular lymphoma (n=1) and chronic lymphocytic leukaemia (n=1).Results Language dysfunction presented within 14 days of CAR-T cell infusion in 16 (84%) patients. Ten (50%) patients had mild word-finding difficulties and 10 (50%) had marked dysphasia with profound word-finding difficulties; the latter were all associated with generalised rhythmic delta activity or generalised periodic discharges on EEG.Conclusions Language dysfunction after CAR-T cell therapy is associated with generalised EEG abnormalities.