Severe reversible toxic encephalopathy induced by cisplatin in a patient with cervical carcinoma receiving combined radiochemotherapy.
METHODS
A 45-year-old patient with cervix carcinoma received combined radiochemotherapy including cisplatin. After a cumulative dose of 240 mg/m(2) the patient suddenly became somnolent and developed a severe tetraparesis and generalized seizures. After ruling out intracranial bleeding, cerebral metastases as well as infectious and metabolic causes of this condition, a severe toxic encephalopathy was diagnosed based on the clinical findings and MRI scans. After symptomatic treatment on the intensive care unit all symptoms were completely reversible.


CONCLUSIONS
Toxic encephalopathy is a rare but dramatic complication of various cytostatic drugs. With the widespread use of cisplatin this rare disorder should be kept in mind.
Sterzing
Florian
F
Department of Radiation Oncology, University of Heidelberg Medical School, Heidelberg, Germany. florian.sterzing@med.uni-heidelberg.de
Grehn
Christian
C
Dinkel
Julien
J
Krempien
Robert
R
Hartung
Gernot
G
Debus
Jürgen
J
Harms
Wolfgang
W
D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001918:Brachytherapy / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D002421:Caudate Nucleus / Q000187:drug effects / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D003131:Combined Modality Therapy; D038524:Diffusion Magnetic Resonance Imaging; D004829:Epilepsy, Generalized / Q000139:chemically induced / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D020644:Midline Thalamic Nuclei / Q000187:drug effects / Q000473:pathology; D009367:Neoplasm Staging; D009460:Neurologic Examination / Q000187:drug effects; D020258:Neurotoxicity Syndromes / Q000175:diagnosis / Q000209:etiology*; D009778:Occipital Lobe / Q000187:drug effects / Q000473:pathology; D011838:Radiation-Sensitizing Agents / Q000008:administration & dosage / Q000009:adverse effects*; D011867:Radioisotope Teletherapy / Q000009:adverse effects; D012075:Remission, Spontaneous; D013788:Thalamus / Q000187:drug effects / Q000473:pathology; D014057:Tomography, X-Ray Computed; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*
D000970:Antineoplastic Agents; D011838:Radiation-Sensitizing Agents; D002945:Cisplatin