Acute Neurotoxicity as an Adverse Event after Oxaliplatine Therapy in Cancer Patients: A Case Report

Abstract

Introduction. Acute oxaliplatin neuropathy has not received much attention and is considered less clinically significant than the chronic form because most cases are transient and reversible within 48-72 hours. However, there are a number of similarities between acute polyneuropathy caused by various chemotherapeutic drugs and acute cerebrovascular accident, although it should be noted that there are also clear differences that are not always obvious to the clinician.

Case description. The article presents a clinical case of acute neurotoxicity after the first administration of oxaliplatin in 47-year-old women with pancreatic adenocarcinoma. She developed neurological symptoms clinically similar to acute cerebrovascular accident (CVA) four hours after oxaliplatin administration. After exclusion of CVA, we used the Oxaliplatin-Associated Neurotoxicity Questionnaire (OANQ) which showed grade 3 neuropathy. Symptoms resolved rapidly within 48 hours after oxaliplatine discontinuation. The article describes the mechanisms of development and clinical manifestations of neurotoxicity. The clinical picture of the transition from acute to chronic neurotoxicity and the possibility of predicting the development of chronic neuropathy are also described.

Conclusion. We wanted to influence the current practice of oncologists by deepening the understanding of the mechanisms and clinical manifestations of acute oxaliplatin-induced polyneuropathy, improving the diagnosis of acute forms of neuropathy, and facilitating the identification of patients at high risk of chronic CTCAE grade III-IV polyneuropathy.