该综述对最近关于免疫检查点抑制剂引起的神经系统副作用（irNAE）的诊断和治疗知识进行了重点介绍，重点关注神经肌肉系统。irNAE主要类似于零星的神经肌肉自身免疫疾病和肿瘤相关的神经系统并发症。然而，在肿瘤学背景下，神经症状可能是非特异性的（肌无力、疲劳），并存在误诊和治疗干预延迟的风险。疾病特异性神经肌肉自身抗体在诊断中的作用存在争议，因为在免疫检查点抑制剂（ICI）治疗之前可能存在先前存在的自身抗体，但没有临床症状，并且在irNAE表现中可能不会发展。新出现的坏死性肌炎（irMyositis）被描述为以面部无力和眼睑下垂模拟重症肌无力。它伴随着高发生率的严重心肌炎，形成了一个三合一重叠综合征（重症肌无力/肌无力/心肌炎）。现代生物制剂在irNAE治疗中的角色尚待确定。irNAE罕见但具有永久性发病率和死亡率的风险。早期怀疑和诊断是预防神经系统后遗症的关键。除了中断ICI的使用，治疗与零星自身免疫疾病相一致。重症肌无力/肌无力/心肌炎重叠综合征值得特别关注，因为它具有最高的死亡风险。对于神经毒性预处理方案、先前亚临床神经系统自身免疫疾病和irNAE后ICI再挑战的风险需要进一步研究。 版权所有 © 2023 Wolters Kluwer Health, Inc. 保留所有权利。

This review highlights recent knowledge on the diagnosis and treatment of immune checkpoint inhibitor-induced neurological side effects (irNAE) focussing on the neuromuscular system.irNAEs mainly resemble sporadic neuromuscular autoimmune diseases and paraneoplastic neurological syndromes. However, neurological symptoms may be unspecific (muscle weakness, fatigue) in the oncological setting and carry the risk of misdiagnosis and delayed therapeutic intervention. The role of disease-specific neuromuscular autoantibodies in the diagnosis is controversial as preexisting autoantibodies may otherwise be present before immune checkpoint inhibitor (ICI) treatment without clinical symptoms and may not develop in case of irNAE manifestation. A new necrotising form of myositis (irMyositis) has been described presenting with facial weakness and ptosis mimicking myasthenia gravis. It comes along with a high rate of severe myocarditis accounting for a triad overlap syndrome (myasthenia/myositis/myocarditis). The role of modern biologicals in the treatment of irNAEs has to be determined.irNAEs are rare but carry the risk of permanent morbidity and mortality. Early suspicion and diagnosis are key to prevent neurological sequelae. Beyond interruption of ICI administration, treatment corresponds to sporadic autoimmune diseases. The myasthenia/myositis/myocarditis overlap syndrome deserves special attention as it carries the highest risk of mortality. The role of neurotoxic pretreatment regimens, preexisting subclinical neurological autoimmune diseases and the risk of ICI-re-challenge after irNAEs has to be further investigated.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.