[Sub-cortico-frontal encephalopathy and choreic movements related to recombinant interferon-alpha 2b].
Interferon (IFN)-alpha is associated with central nervous system (CNS) side effects such as depression and suicide ideation, somnolence, confusion, drowsiness, psychomotor slowing, memory impairment and visual disorientation. More severe complications are uncommon and include frank paranoia, dementia, coma, seizures and neuropathy. With the increasing long-term and extensive use of interferon (IFN)-alpha several new neurologic adverse effects have been recognized. We report on two patients who developed severe subcortico-frontal impairment, associated in one case with choreic movements, after a long-term treatment with IFN-alpha 2b for hematologic malignancies. Our patients rapidly and completely recovered from their cognitive and motor symptoms after the discontinuation of the drug. The same neurologic symptoms reappeared when we attempted to reintroduce lower doses of IFN-alpha in one case. Although little is known regarding IFN-alpha actions in the CNS, several possible mechanisms may underlie its neurotoxicity and might result from complex direct and indirect effects involving brain vasculature, neuroendocrine system, neurotoxic secondary cytokines'release and neurotransmitters.
Moulignier
A
A
Fondation Adolphe de Rothschild, Service de Neurologie, 25 Rue Manin, 75940 Paris Cedex 19. amoulignier@fo-rothschild.fr
Allo
S
S
Singer
B
B
Monge-Strauss
M F
MF
Zittoun
R
R
Gout
O
O
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001259:Ataxia / Q000139:chemically induced; D002493:Central Nervous System Diseases / Q000139:chemically induced*; D002819:Chorea / Q000139:chemically induced*; D003072:Cognition Disorders / Q000139:chemically induced*; D003131:Combined Modality Therapy; D003221:Confusion / Q000139:chemically induced; D005260:Female; D005625:Frontal Lobe / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects* / Q000494:pharmacology; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000494:pharmacology; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy; D008569:Memory Disorders / Q000139:chemically induced*; D009101:Multiple Myeloma / Q000628:therapy; D009483:Neuropsychological Tests; D011712:Pyramidal Tracts / Q000187:drug effects* / Q000503:physiopathology; D011994:Recombinant Proteins
D007155:Immunologic Factors; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins
Encéphalopathie sous-cortico-frontale et mouvements choréiques liés à l'interféron-alpha 2b recombinant.