Clinical and Electrophysiological Characteristics of Vincristine Induced Peripheral Neuropathy in Children

ABSTRACT Background: Vincristineis a chemotherapeutic agent frequently used in the treatment of childhood cancer. Peripheral neuropathyis an important side effect of Vincristine. We assessed the incidence, severity and type of peripheral neuropathyin children on Vincristineusing clinical parameters and nerve conduction studies. Methods : Children with cancer treated with Vincristinewere enrolled. Symptoms and signs of motor, sensory and autonomic peripheral neuropathyat baseline and at 3, 6 and 12 month follow up were documented. A modified total neuropathy score grading was undertaken. Nerve conduction studies(NCS) were undertaken and vitamin Elevels measured at the time of these assessments. Results: 28 patients were enrolled over 12 months. 93% had evidence of neuropathy clinically and/or electrophysiologically. Weakness, pain and constipation were the most common symptoms and the most common sign was loss of ankle reflexes. The peripheral neuropathywas mild in most cases. Plasma levels of vitamin Eremained in the normal range, however they dropped significantly from the baseline value. Conclusions: Peripheral neuropathyassessed clinically and electrophysiologically, occurs in the majority of children on Vincristinetreatment. The neuropathy is sensory-motor and generally mild. There was a statistically significant drop in average vitamin Elevels during treatment. Keywords: Vincristine, peripheral neuropathy, vitamin E