[Painful hyperexcitability syndrome with oxaliplatin containing chemotherapy. Clinical features, pathophysiology and therapeutic options].
The platinum derivative oxaliplatin is widely used in colorectal cancer. Its side effects differ from those of the other platinum compounds cisplatin and carboplatin. An acute, painful hyperexcitability syndrome (HES) accompanied by cold induced paresthesia, dysesthesia and myotonia is unique to oxaliplatin, whereas a chronic, peripheral sensory neuropathy (PSN) can be caused by all platinum compounds. It is believed that HES is the result of peripheral nerve hyperexcitability as a consequence of voltage-gated sodium channel dysfunction, which may be caused by calcium level imbalance. Therapeutic options for HES are the administration of calcium and magnesium, the serotonin and noradrenaline reuptake inhibitor (SNRI) venlafaxine and the thiophosphate amifostine.
Kowalski
T
T
Neurologische Klinik, Knappschaftskrankenhaus Bochum-Langendreer, Ruhr-Universität Bochum, In der Schornau 23-25, 44892, Bochum, Deutschland. thomas.kowalski@kk-bochum.de
Maier
C
C
Reinacher-Schick
A
A
Schlegel
U
U
D018759:Adrenergic Uptake Inhibitors / Q000627:therapeutic use; D004999:Amifostine / Q000627:therapeutic use; D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002119:Calcium Carbonate / Q000627:therapeutic use; D002125:Calcium Gluconate / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy*; D003511:Cyclohexanols / Q000627:therapeutic use; D006801:Humans; D006930:Hyperalgesia / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology; D015636:Magnesium Chloride / Q000627:therapeutic use; D009412:Nerve Fibers / Q000187:drug effects / Q000502:physiology; D020258:Neurotoxicity Syndromes / Q000188:drug therapy / Q000503:physiopathology*; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D000077150:Oxaliplatin; D010292:Paresthesia / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology; D010525:Peripheral Nerves / Q000187:drug effects / Q000503:physiopathology; D051381:Rats; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D015222:Sodium Channels / Q000187:drug effects / Q000502:physiology; D000069470:Venlafaxine Hydrochloride
D018759:Adrenergic Uptake Inhibitors; D004999:Amifostine; D000970:Antineoplastic Agents; D002119:Calcium Carbonate; D002125:Calcium Gluconate; D003511:Cyclohexanols; D015636:Magnesium Chloride; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D017367:Selective Serotonin Reuptake Inhibitors; D015222:Sodium Channels; D000069470:Venlafaxine Hydrochloride