Skip to main content
SpringerLink
Log in

Vincristine induced cranial polyneuropathy

  • Clinical Brief
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Quasthoff S, Hartung HP. Chemotherapy-induced peripheral neuropathy.J Neurol 2002; 249: 9–17.

    Article  PubMed  CAS  Google Scholar 

  2. Chauvenet AR, Shashi V, Selsky C, Morgan E, Kurtzberg J, Bell B Vincristine-induced neuropathy as the initial presentation of charcot-marie-tooth disease in acute lymphoblastic leukemia: a Pediatric Oncology Group study.J Pediatr Hematol Oncol 2003; 25: 316–320.

    Article  PubMed  Google Scholar 

  3. Moudgil SS, Riggs JE. Fulminant peripheral neuropathy with severe quadriparesis associated with vincristine therapy.Ann Pharmacother 2000; 34: 1136–1138.

    Article  PubMed  CAS  Google Scholar 

  4. Legha SS. Vincristine neurotoxicity. Pathophysiology and management.Med Toxicol 1986; 1: 421–427.

    PubMed  CAS  Google Scholar 

  5. Yetgin S, Tuncer MA, Cetin Met al. Benefit of high-dose methylprednisolone in comparison with conventional-dose prednisolone during remission induction therapy in childhood acute lymphoblastic leukemia for long-term follow-up.Leukemia 2003; 17: 328–333.

    Article  PubMed  CAS  Google Scholar 

  6. Chan JD. Pharmacokinetic drug interactions of vinca alkaloids: summary of case reports.Pharmacotherapy 1998; 18: 1304–1307.

    PubMed  CAS  Google Scholar 

  7. Neumann Y, Toren A, Rechavi Get al. Vincristine treatment triggering the expression of asymptomatic Charcot-Marie-Tooth disease.Med Pediatr Oncol 1996; 26: 280–283.

    Article  PubMed  CAS  Google Scholar 

  8. Jackson DV, Jr., Pope EK, McMahan RAet al. Clinical trial of pyridoxine to reduce vincristine neurotoxicity.J Neurooncol 1986; 4: 37–41.

    Article  PubMed  Google Scholar 

  9. Battle WM, Snape WJ, Jr. Alavi Aet al. Colonic dysfunction in Diabetes mellitusGastroenterology 1980; 79: 1217–1221.

    PubMed  CAS  Google Scholar 

  10. Muller L, Kramm CM, Tenenbaum T, Wessalowski R, Gobel U. Treatment of vincristine-induced bilateral ptosis with pyridoxine and pyridostigmine.Pediatr Blood Cancer 2004; 42: 287–288.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Hematology, Yuzuncu Yil University Faculty of Medicine, 65200, Van, Turkey

    Ali Bay (Fellow in Pediatric hematology)

  2. Division of neurology, Yuzuncu Yil University Faculty of Medicine, 65200, Van, Turkey

    Cahide Yilmaz (Fellow in Pediatric neurology)

  3. Division of neurosurgery, Yuzuncu Yil University Faculty of Medicine, 65200, Van, Turkey

    Nebi Yilmaz (Assistant professor)

  4. Yüzüncü Yýl University Faculty of Medicine, 65200, Van, Turkey

    Ahmet Faik Oner (Professor of Pediatrics and Pediatric Hematologist)

Authors
  1. Ali Bay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cahide Yilmaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nebi Yilmaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ahmet Faik Oner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cahide Yilmaz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bay, A., Yilmaz, C., Yilmaz, N. et al. Vincristine induced cranial polyneuropathy. Indian J Pediatr 73, 531–533 (2006). https://doi.org/10.1007/BF02759902

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02759902

Key words

Search

Navigation