Vincristine induced cranial polyneuropathy.
We describe a 5-year-old girl showed recovery of vincristine induced cranial polyneuropathy with pyridoxine and pyridostigmine treatment. A 5-year-old girl was diagnosed preB cell Acute Lymphoblastic Leukemia (ALL). She received chemotherapy according to the previously described modified St. Jude total therapy studies XIII. Five days after the fourth dose of vincristine, she presented with bilateral ptosis. Neurological examination revealed bilateral ptosis, and complete external opthalmoplegia with normal pupillary and corneal reflexes. She received 3.8 mg cumulative dose of vincristin before development of ptosis. A neuroprotective and neuroregenerative treatment attempt with pyridoxine and pyridostigmine was initiated. The bilateral ptosis markedly improved after 7 days of pyridoxine and pyridostigmine treatment and completely resolved after two weeks. The both agents were given for 3 weeks and were well tolerated without any side effects. During the follow up period we did not observe residue or recurrence of the ptosis.
Bay
Ali
A
Yuzuncu Yil University Faculty of Medicine, Division of Hematology, Van, Turkey. bayalibay@yahoo.com
Yilmaz
Cahide
C
Yilmaz
Nebi
N
Oner
Ahmet Faik
AF
D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D001763:Blepharoptosis / Q000139:chemically induced / Q000188:drug therapy; D002675:Child, Preschool; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003389:Cranial Nerve Diseases / Q000139:chemically induced* / Q000188:drug therapy; D005260:Female; D006801:Humans; D009886:Ophthalmoplegia / Q000139:chemically induced / Q000188:drug therapy; D011115:Polyneuropathies / Q000139:chemically induced* / Q000188:drug therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D011736:Pyridoxine / Q000627:therapeutic use; D014750:Vincristine / Q000009:adverse effects*; D014803:Vitamin B Complex / Q000627:therapeutic use*
D000972:Antineoplastic Agents, Phytogenic; D002800:Cholinesterase Inhibitors; D014803:Vitamin B Complex; D014750:Vincristine; D011736:Pyridoxine; D011729:Pyridostigmine Bromide