Neurological complications of chemotherapy to the peripheral nervous system

Neuropathy of Connective Tissue Diseases and Other Systemic Diseases

“…Halting the responsible chemotherapeutic agent has variable effects on the neuropathy. 79,80 Targeted treatment for these neuropathies is limited, and therapies generally focus on symptom relief. Several agents have been investigated for use as a preventative measure against development of neuropathy, including oxcarbazepine, magnesium, calcium, vitamin E, and glutathione.…”

“…Electrophysiologic testing demonstrates distal axonopathy with minimal slowing of conduction velocities. 79 Interestingly, tibial H-reflexes are often found even in patients with ankle areflexia. 83 The severity of PN is dose-dependent, and resolution of symptoms generally follows discontinuation of the medication.…”

Drug-Induced Disorders of the Nervous System

“…Cisplatin and carboplatin cause a dorsal root ganglion neuronopathy rather than an axonopathy. 135,140 Misonidazole and other compounds related to metronidazole are used as radiosensitizing agents in cancer therapy, and may also cause a sensory neuropathy. 134,136 The taxanes paclitaxel and docetaxel, which act by causing aggregation of microtubules, can cause a predominantly sensory or sensorimotor axonal neuropathy affecting large-diameter myelinated sensory and motor fibers.…”

“…Oxaliplatin, which interferes with axonal ionic conductance, causes transient sensory symptoms after intravenous administration, but persistent symptoms of neuropathy may develop after repeated infusions. 133,135 Podophyllin derivatives, which have been used to treat disseminated malignancy and also are constituents of certain laxative preparations and topical agents, may cause a peripheral neuropathy that is sometimes associated with signs of myelopathy. 137 Coadministration of other neurotoxic drugs such as cisplatin increases this risk.…”

“…Dapsone may cause a predominantly motor neuropathy after prolonged high-dose therapy for leprosy, certain dermatologic conditions, or for prophylaxis of Pneumocystis carinii pneumonia. 168,169 A demyelinating neuropathy resembling chronic inflammatory demyelinating polyneuropathy has been reported in patients treated with tacrolimus, 135,170,171 and in a patient treated with interferon-α. [163][164][165] Chronic administration of high doses of pyridoxine may cause a severe sensory polyneuropathy of insidious onset, and paresthesias may develop even in some patients taking conventional doses.…”