Thalidomide neuropathy in childhood.
Thalidomide was withdrawn from world markets in 1961 following recognition of its teratogenic effects. More recently, however, thalidomide treatment has been reintroduced to adult and paediatric practice for a variety of dermatologic, immunologic, rheumatologic and neoplastic disorders. Neuropathy is a significant side effect of thalidomide therapy, which may limit its clinical use. We report four cases of sensorimotor axonal neuropathy in children aged 10-15 years, treated with thalidomide for myxopapillary ependymoma, Crohn's disease and recurrent giant aphthous ulceration. Thalidomide neuropathy is often associated with proximal weakness and may progress even after discontinuation of treatment, in the phenomenon of 'coasting'. Children treated with thalidomide should undergo regular neurophysiologic studies in order to detect presymptomatic or progressive peripheral neuropathy.
Fleming
Fiona J
FJ
Institute for Neuromuscular Research, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney 2145, NSW, Australia.
Vytopil
Michal
M
Chaitow
Jeffrey
J
Jones
H Royden
HR
Darras
Basil T
BT
Ryan
Monique M
MM
D000200:Action Potentials / Q000187:drug effects / Q000502:physiology; D000293:Adolescent; D001932:Brain Neoplasms / Q000188:drug therapy; D002648:Child; D003424:Crohn Disease / Q000188:drug therapy; D018450:Disease Progression; D004576:Electromyography; D004806:Ependymoma / Q000188:drug therapy; D020233:Gait Disorders, Neurologic / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D018908:Muscle Weakness / Q000139:chemically induced / Q000473:pathology / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000294:innervation / Q000473:pathology / Q000503:physiopathology; D009431:Neural Conduction / Q000187:drug effects / Q000502:physiology; D009460:Neurologic Examination / Q000592:standards; D009498:Neurotoxins / Q000009:adverse effects; D010525:Peripheral Nerves / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D013792:Thalidomide / Q000009:adverse effects*; D014456:Ulcer / Q000188:drug therapy; D028761:Withholding Treatment
D009498:Neurotoxins; D013792:Thalidomide