Posterior leukoencephalopathy following cisplatin, bleomycin and vinblastine therapy for germ cell tumor of the ovary.
A 31-year-old female developed multiple episodes of grand mal seizures after combination chemotherapy with cisplatin, vinblastine and bleomycin for germ cell ovarian cancer stage Ic. The clinicoradiologic features in this patient were consistent with posterior leukoencephalopathy, which is a rare complication of chemotherapy. Seizures were controlled by the anticonvulsive agent Dilantin (Pfizer, Khet Klongtoey, Bangkok) and she returned home without any permanent neurologic deficits. Follow-up magnetic resonance imaging 2 weeks later showed complete resolution of the abnormalities. This syndrome has been previously reported following cisplatin-based chemotherapy. Physicians should remain alert to the potential hazards of chemotherapy to the central nervous system. Risks and benefits should be seriously considered before starting treatment.
Sueblinvong
Thanasak
T
Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Pathumwan, Bangkok, Thailand. stanasak@hotmail.com
Noophun
Phadet
P
Pataradool
Kamol
K
Suwanwela
Nitaya
N
Phanthumchinda
Kammant
K
Tresukosol
Damrong
D
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001761:Bleomycin / Q000009:adverse effects; D001927:Brain Diseases / Q000139:chemically induced* / Q000175:diagnosis; D002945:Cisplatin / Q000009:adverse effects; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D010672:Phenytoin / Q000627:therapeutic use; D012640:Seizures / Q000188:drug therapy / Q000209:etiology; D014057:Tomography, X-Ray Computed; D014747:Vinblastine / Q000009:adverse effects
D000927:Anticonvulsants; D001761:Bleomycin; D014747:Vinblastine; D010672:Phenytoin; D002945:Cisplatin