A curious case of oxaliplatin-induced neurotoxicity: recurrent, self-limiting dysarthria

J Oncol Pharm Pract. 2014 Oct;20(5):393-6. doi: 10.1177/1078155213506477. Epub 2013 Oct 8.

Abstract

This report presents a unique case of oxaliplatin-induced neurotoxicity featuring acute, recurrent, self-limiting dysarthria following multiple subsequent infusions of oxaliplatin. A 65-year-old man started chemotherapy for metastatic pancreatic adenocarcinoma with oxaliplatin-irinotecan-leucovorin-5-fluorouracil (FOLFIRINOX). During the first and subsequent infusions of oxaliplatin, the patient developed episodes of dysarthria that lasted between 2 and 4 h after oxaliplatin infusions, followed by their complete and uneventful resolution. A thorough neurological examination showed no new neurologic deficits except for very fine tongue fasciculations. Recognizing this self-limiting toxic effect of oxaliplatin is important in order to avoid dose reductions that may affect clinical outcomes.

Keywords: FOLFIRINOX; Oxaliplatin; dysarthria; neurotoxicity.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / secondary
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives
  • Drug Administration Schedule
  • Dysarthria / chemically induced*
  • Dysarthria / diagnosis
  • Fluorouracil / administration & dosage
  • Humans
  • Irinotecan
  • Leucovorin / administration & dosage
  • Male
  • Neurotoxicity Syndromes / diagnosis
  • Neurotoxicity Syndromes / etiology*
  • Organoplatinum Compounds / administration & dosage
  • Organoplatinum Compounds / adverse effects
  • Oxaliplatin
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / pathology
  • Recurrence
  • Time Factors

Substances

  • Organoplatinum Compounds
  • Oxaliplatin
  • Irinotecan
  • Leucovorin
  • Fluorouracil
  • Camptothecin