Oculomotor Disturbances Associated with 5-Fluorouracil Chemotherapy

Bixenman, Wayne W.; Nicholls, Jack I.; Warwick, O. H.

doi:10.1016/0002-9394(77)90904-7

Cited by 42 publications

(8 citation statements)

References 11 publications

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“…The cerebellar syndromes caused by HDARAC and the chemotherapeutic agent 5-fluorouraci1{20, 42,4? ] have several clinical features in common: the incidence is dose related [23, 471; symptoms abate when the drug is discontinued; and each sometimes is accompanied by a transient ocular palsy [6]. Adult cats given the pyrimidine antimetabolite 5fluoro-orotic acid became ataxic five to ten days later [22), a delay similar to that observed in patients given HDARAC.…”

Section: Discussionmentioning

confidence: 99%

Cerebellar degeneration caused by high‐dose cytosine arabinoside: A clinicopathological study

Winkelman

Hines

1983

Annals of Neurology

136

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Twenty-four patients with leukemia or lymphoma refractory to conventional chemotherapy were given a course of systemic, high-dose cytosine arabinoside (3 gm/m2 every 12 hours for twelve doses). Four patients developed cerebellar degeneration during treatment. Ataxia of gait and limb movements, dysarthria, and nystagmus appeared five to seven days after the first dose, worsened over the next two to three days, and then remained stable for two to six days. Incomplete improvement occurred over the following one to two weeks. Postmortem examination disclosed loss of Purkinje cells in the depths of cortical sulci with relative preservation of those at the crests of folia and those in the most posterior inferior portions of the cerebellum. Other patients developed a mild, reversible cerebellar syndrome over the same time course as that of the irreversible disorder. Manifestations ranged from nystagmus alone to dysarthria and unsteadiness of gait without limb ataxia. We conclude that cytosine arabinoside at this dosage causes a cerebellar degeneration with characteristic clinical and pathological features. Among the present patients with refractory hematological malignancies, such degeneration occurred with an incidence of 16.7%, more than twice that reported in previous series.

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Section: Discussionmentioning

confidence: 99%

Cerebellar degeneration caused by high‐dose cytosine arabinoside: A clinicopathological study

Winkelman

Hines

1983

Annals of Neurology

136

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“…The pyrimidine analogue antimetabolite (inhibitor of thymidine synthetase) 5-FU causes ocular toxicity in an estimated 25-38% of patients treated with the drug either alone or in a combination-regimen. Ocular toxicities include usually mild-to-moderate blurred vision, ocular pain, photophobia, excessive lacrimation, eye irritation, conjunctivitis, circumorbital edema, ectropion, keratitis (8,22), inhibition of mitosis of retinal pigment epithelial cells and fibrocytes (23) and other effects (24)(25)(26)(27)(28)(29).…”

Section: -Fluorouracilmentioning

confidence: 99%

Effects on the visual system might contribute to some of the cognitive deficits of cancer chemotherapy-induced ‘chemo-fog’

Raffa

Tallarida

2010

Journal of Clinical Pharmacy and Therapeutics

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SUMMARY The diminution in certain aspects of cognitive function that is reported to occur in some patients during or after adjuvant cancer chemotherapy is variously known as ‘chemo-fog’, ‘chemo-brain’ or other such term. In addition to reported deficits in attention, concentration and other functions, most, if not all, of the studies report deficits involving visual-spatial function or visual memory. Since the visual system is part of the nervous system, it seems reasonable to ask if it is susceptible to some of the deleterious effects produced by adjuvant chemotherapeutic drugs. We propose here the possibility that some portion of the vision-related aspects of the ‘chemo-fog’ spectrum of cognitive deficits results from a direct action of the adjuvant drugs on the visual system or from drug / drug or site / site interaction between effects on the visual system and other critical brain regions.

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“…Paresis of convergence has been described with 5-fluorouracil. 25 Kattah, Silgals, Manz, Toro, Dritschilo, Smith While upper eyelid ptosis is frequent in patients with vincristine neuropathy, ophthalmoplegia is not as frequent. Among twenty subjects treated with vincristine by Albert, Wong, and Henderson, individual extraocular muscle palsies and ptosis developed in thirteen patients; five of whom had lateral rectus paresis;26 the ophthalmoplegia in their cases was dose-related and reversible after discounting the drug.…”

Section: Methodsmentioning

confidence: 99%

Presentation and management of parasellar and suprasellar metastatic mass lesions.

Kattah¹,

Silgals²,

Manz³

et al. 1985

Journal of Neurology, Neurosurgery & Psychiatry

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Oculomotor Disturbances Associated with 5-Fluorouracil Chemotherapy

Cited by 42 publications

References 11 publications

Cerebellar degeneration caused by high‐dose cytosine arabinoside: A clinicopathological study

Cerebellar degeneration caused by high‐dose cytosine arabinoside: A clinicopathological study

Effects on the visual system might contribute to some of the cognitive deficits of cancer chemotherapy-induced ‘chemo-fog’

Presentation and management of parasellar and suprasellar metastatic mass lesions.

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