title: Vincristine-induced cranial neuropathy.
abstract: Vincristine (VCR) is a vinca alkaloid that is used for treatment of many malignancies. The vinca alkaloids are neurotoxic, usually causing a peripheral neuropathy, but cranial neuropathies are rare as side effects. Described here is the case of a 2.5-year-old boy, a known case of Wilms' tumor, treated by vincristine (0.067 mg/kg/day) and dactinomycin (0.045 mg/kg/day) after surgery. Three weeks after treatment, he presented with bilateral ptosis. Neurological examination revealed bilateral ptosis with normal pupillary reflex and eye movement. He received 3.015 mg cumulative dose of vincristine before development of ptosis. Treatment with pyridoxine (150 mg/m2 p.o. BID) and pyridostigmine (3 mg/kg p.o. BID) was started as neuroprotective agents, and after 7 days the problem disappeared. The treatment continued for 6 weeks and there were no signs of ptosis or a recurrence in follow up 2 months later.
authors.affiliation: Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran ; Department of Pediatrics, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Talebian
authors.affiliation: Department of Pediatrics, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Razieh Moazam
authors.initials: RM
authors.lastname: Goudarzi
authors.affiliation: Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran ; Department of Pediatrics, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Mohammadzadeh
authors.affiliation: Department of Pediatrics, Kashan University of Medical Sciences, Kashan, Iran.
authors.forename: Azadeh Sadat
authors.initials: AS
authors.lastname: Mirzadeh
keywords: Ptosis; Side effect; Vincristine; Wilms’ tumor