title: Severe Generalized Weakness, Paralysis, and Aphasia following Administration of Irinotecan and Oxaliplatin during FOLFIRINOX Chemotherapy.
abstract: BACKGROUND
  Irinotecan is commonly used in combination with oxaliplatin as a component of FOLFIRINOX chemotherapy for several gastrointestinal malignancies. The purpose of this case report is to describe a patient who developed acute paralysis and aphasia while receiving her initial infusion of irinotecan.
  
  
  METHODS
  A 67-year-old woman with newly diagnosed metastatic pancreatic adenocarcinoma presented for her first cycle of FOLFIRINOX chemotherapy. During her infusion of irinotecan, she developed acute onset of generalized weakness, paralysis of all extremities, and nonfluent aphasia with complete inability to communicate. This episode was self-limited and resolved within 2 h. Prior to subsequent infusions she received intravenous repletion of potassium and had no recurrence of symptoms.
  
  
  CONCLUSIONS
  In selected cases, coadministration of irinotecan and oxaliplatin may result in severe generalized weakness and aphasia, which may be triggered by underlying electrolyte disturbances. Careful monitoring and correction of potassium may help prevent this reaction.
authors: University of Chicago (North Shore), North Shore University Health System, Evanston, Ill., USA.
authors: Manisha
authors: M
authors: Chandar
authors: Kellogg Cancer Center, North Shore University Health System, Evanston, Ill., USA.
authors: Robert
authors: R
authors: de Wilton Marsh
keywords: Aphasia; Dysarthria; FOLFIRINOX; Irinotecan; Neurologic side effects; Oxaliplatin; Paralysis; Weakness