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chemotherapy and neuroapraxia
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chemotherapy and neuroapraxia - January 2, 2005 2:41:00 AM
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ayatz
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Joined: June 29, 1998
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Is it possible that chemotherapy for a lung cancer can destroy neural cells and cause neyroapraxia or axial paralysis even to distant nerves ?
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Re: chemotherapy and neuroapraxia - January 2, 2005 5:35:00 AM
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jma
Posts: 2312
Joined: August 24, 2000
From: NY
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Hello,
I have never heard of this. However, a quick Pubmed search does not show any studies that shows this. Of course, the search may have to be modified with different search terms to find what you are looking for. Give it a try. Of course, it pays to know the terminology for the chemotherapy agents used for treating cancer cells.
JMA
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Re: chemotherapy and neuroapraxia - January 3, 2005 8:10:00 AM
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Shill
Posts: 1056
Joined: February 13, 2003
From: Madison WI USA
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Ayatz,
Yes, it is possible. I just learned this myself, with a young man dealing with rhabdomyosarcoma. Apparently, the medication of "Vanchristine" (and I have NO idea on how it is actually spelled), used for chemo, can cause distal neuropathy, and apparently has in this gentleman's case. (foot drop). If you can spell it better than I can, look it up on pub Med.
Good Luck,
Steve
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Steve Hill PT
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Re: chemotherapy and neuroapraxia - January 5, 2005 4:12:00 AM
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Shill
Posts: 1056
Joined: February 13, 2003
From: Madison WI USA
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Here is the Vincristine information. (now spelled correctly).
Taken directly from a micromedex drug index listing.
One study reported the development of moderately severe PERIPHERAL NEUROPATHY in 2 of 8 patients being treated with vincristine (1 to 4 mg every 1 to 4 weeks, intravenously) for multiple myeloma in stable partial remission. Vincristine was discontinued in the 2 patients who developed peripheral neuropathy (Alberts et al, 1977). Another study reported the development of severe POLYNEUROPATHY with bulbar paralysis, paresis, disturbances of speech and swallowing and finally death due to RESPIRATORY PARALYSIS. The patient was being treated with vincristine (1.5 milligrams/square meter every 7 to 10 days) for acute lymphatic leukemia (Abbrederis et al, 1974).
the case I am seeing hasnt improved yet. (one month)
Steve
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Steve Hill PT
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Re: chemotherapy and neuroapraxia - January 24, 2005 2:41:00 AM
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Alex Brenner PT MPT OCS
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Joined: February 29, 2004
From: Kentucky
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Hi Ayatz. I do EMGs for the Army and I know that I have seen this in a couple of cases. I will have to look for the reference but there is evidence to show that chemotherapy can result in neruopathy. Sometimes it is not apparent until years after the chemotherapy. I have seen both myelinopathy and axonopathy in multiple nerves of the upper and lower extremities in people that have had chemotherapy.
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Alex Brenner, PT, MPT, OCS
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Re: chemotherapy and neuroapraxia - January 24, 2005 2:52:00 AM
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Alex Brenner PT MPT OCS
Posts: 1057
Joined: February 29, 2004
From: Kentucky
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Ayatz,
Daniel Dumitru's text, Electrodiagnostic Medicine. 2002. 2nd Ed. Hanley and Belfus, INC. Philadelphia has a section on Toxic Neuropathies, specifically chemotherapy.
"The commonly used anticancer drugs that can cause neuropathies fall mainly into three groups. The clinical manifestations of neuropathy are somewhat different for various agents. When symptoms first begin, nerve conduction studies are often normal. With further doses, abnormalities eventually occur but again may differ with the various chemotherapy drugs. These agents generally produce neuropathy in a dose-dependent relationship; the higher the dose and the longer the time of exposure; the more likely a neuropathy will occur....
The text goes quite into detail regarding the mechanism etc. It may be worth checking out and reading.
Also, the term neuropraxia to me makes me think of just a temporary blockage which recovers in just a few minutes. Most of these people have full blown neuropathies which may take much longer to recover from if at all.
Hope this helps.
Army
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Alex Brenner, PT, MPT, OCS
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Re: chemotherapy and neuroapraxia - January 27, 2005 6:21:00 PM
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freetomove
Posts: 46
Joined: October 17, 2003
From: Nova Scotia, Canada
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Hi Army,
Good info. Can PT influence recovery in your experience? If so, how?
My three year-old daughter received vincristine for four months last summer for treatment for liver cancer. She initially experienced pain and was unwilling to walk, then demonstrated very noticeable changes in gait with little complaint of pain, periodic recovery (possibly dose-related?), and then pain and gait abnormality together. About three months after her last dose of vincristine there was marked improvement and seems to be little residual impairment aside from sluggish reflexex, which I have not checked recently.
Any info. on pediatric cases or long-term effects?
Thanks,
Nick
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Re: chemotherapy and neuroapraxia - January 30, 2005 11:23:00 PM
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Alex Brenner PT MPT OCS
Posts: 1057
Joined: February 29, 2004
From: Kentucky
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Hi Nick. I really do not have much experience working with pediatrics and certainly do not feel qualified to make any comments concerning your daughters recovery. I have seen probably two cases of chemical induced neuropathy both were in older people (60's) and I cant say that I saw much recovery. I would think that your daughter would have a better chance for recovery being that she is so young. You may want to address this question in the Pediatric Forum. Possibly Dr. Ball may have more information for you.
I wish you and your daughter well.
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Alex Brenner, PT, MPT, OCS
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