Oxaliplatin-Induced Lhermitte’s Sign in Gastric Cancer

Abstract

A 64-year-old Japanese man with no significant medical history presented with epigastric discomfort of 2-weeks’ duration. He was diagnosed with metastatic HER2-positive gastric cancer. Chemotherapy with capecitabine, oxaliplatin, and trastuzumab was initiated. During the eighth cycle, he suddenly complained of electric shock-like pain in both legs upon neck flexion, consistent with Lhermitte’s sign. Oxaliplatin was discontinued, and Lhermitte’s sign resolved after 3 months. Neurotoxicity is commonly observed in platinum-based chemotherapy, but Lhermitte’s sign is rare. This is the first report of oxaliplatin-induced Lhermitte’s sign in a gastric cancer patient.

Oxaliplatin-Induced Neuropathy: Genetic and Epigenetic Profile to Better Understand How to Ameliorate This Side Effect

“…Another side effect of oxaliplatin treatment was observed by Okamoto in a Japanese patient who reported the Lhermitte's sign, a sudden sensation resembling an electric shock that passes down the back of the neck and into the spine and may then radiate out into the arms and legs. This symptom mainly occurs in multiple sclerosis and is believed to be due to a demyelination of the posterior columns of the spinal cord induced by chemotherapy (Okamoto et al, 2020).…”