Cisplatin-induced non-convulsive encephalopathy.
Cisplatin is a widely used chemotherapeutic agent implicated in a range of adverse effects affecting the nervous system. Among the others, convulsive encephalopathy is rare and its pathogenesis is unknown. We report an 84-year-old woman with adenocarcinoma of the ovary who developed two fully reversible episodes of non-convulsive encephalopathy, each following a course of cisplatin-based chemotherapy and thus confirming a causal relationship to the agent. The patient presented 7 and 10 days after treatment with acute confusional state, a partial left homonymous hemianopia and a left extinction hemihypesthesia. Brain MRI showed old-standing cerebral microvascular changes and EEG revealed right parieto-occipital periodic lateralized epileptiform discharges over a generalized background activity slowing. This case adds further to the clinical diversity of cisplatin toxicity and, in view of the similarity to a recently defined disorder of posterior leukoencephalopathy, suggests regional endovascular injury rather than a direct cerebral toxicity as the initial event in the evolution of encephalopathy.
Lyass
O
O
Department of Oncology, Hadassah University Hospital and Hebrew University-Hadassah Medical School, Jerusalem, Israel.
Lossos
A
A
Hubert
A
A
Gips
M
M
Peretz
T
T
D000231:Adenocarcinoma, Papillary / Q000097:blood / Q000188:drug therapy*; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001927:Brain Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D002945:Cisplatin / Q000009:adverse effects*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010051:Ovarian Neoplasms / Q000097:blood / Q000188:drug therapy*
D000970:Antineoplastic Agents; D002945:Cisplatin