engleski

VIPN (Vincristine Induced Peripheral Neuropathy) – Neurological complications of Oncology treatment

Introduction: In the past few decades there is an increase in survival among children with malignancies thanks to the new oncological protocols and newer chemotherapeutics. Despite this, we are still facing with complications of those treatments, and one of those complications are peripheral neuropathies which are linked to chemotherapeutics like vincas, taxanes and platins. One of the most commonly used chemotherapeutic agent in children is vincristine. Vincristine induced polyneuropathy (VIPN) is dose dependent and occurs with an incidence of 30% -80% of which severe forms occur in 1.6% to 7%. The symptoms of the disorder can be classified into three major categories: sensory, motor and autonomic. Methods: The aim is to point out the need to monitor development of neurological complications in oncology patients like VIPN, ability to use EMNG in monitoring those children and timely modification of oncological treatment to prevent evolution of severe forms. In the past 2, 5 years in Children’s Hospital Zagreb nerve conduction studies were done in sixteen children treated with VCR. The reason for EMNG was the development of clinical symptoms of polyneuropathy, high cumulative dose of VCR or neurological symptoms that may indicate leukemic infiltration of the CNS. Results: Eight of sixteen had NCS signs of motor VIPN, two developed severe motor polyneuropathy and VCR was replaced by another chemotherapeutic. Three of sixteen children developed sensory- motor VIPN and two sensory VIPN. Conclusion: VIPN is a significant clinical problem in children treated with VCR and can result in chronic pain, limited mobility, loss of proprioception and balance. VIPN is particularly demanding for detection and monitoring in pediatric patients and it is important to use multidisciplinary approach because modification of therapy can help improve long-term quality of life.

VIPN ; vincristine induced peripheral neuropathy ; neurological complications ; oncology treatment

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