Fulminant peripheral neuropathy with severe quadriparesis associated with vincristine therapy.
OBJECTIVE
To report a case of fulminant neuropathy with severe quadriparesis associated with vincristine chemotherapy.


METHODS
A 48-year-old white man with acute lymphoblastic leukemia was started on an induction chemotherapeutic regimen that included intravenous vincristine. He received a total of 6 mg of vincristine over two weeks during induction chemotherapy. Over the next two weeks, he developed a fulminant peripheral neuropathy with severe quadriparesis.


CONCLUSIONS
Although commonly associated with peripheral neuropathy, vincristine neurotoxicity only rarely involves instances of fulminant peripheral neuropathy with severe quadriparesis. Guillain-Barré syndrome is also associated with leukemia and may present as a fulminant peripheral neuropathy with severe quadriparesis.


CONCLUSIONS
Fulminant neuropathy with severe quadriparesis occurring in patients with leukemia being treated with vincristine (and who do not have coexistent Charcot-Marie-Tooth disease) is more likely due to Guillain-Barré syndrome than to vincristine neurotoxicity.
Moudgil
S S
SS
Department of Neurology, West Virginia University Health Sciences Center, Morgantown 26506, USA.
Riggs
J E
JE
D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects* / Q000627:therapeutic use; D017809:Fatal Outcome; D020275:Guillain-Barre Syndrome / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000473:pathology; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications / Q000188:drug therapy; D011782:Quadriplegia / Q000139:chemically induced*; D014750:Vincristine / Q000009:adverse effects* / Q000627:therapeutic use
D000972:Antineoplastic Agents, Phytogenic; D014750:Vincristine