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Related Experiment Videos

Ifosfamide encephalopathy presenting with asterixis.

Thomas Meyer1, Albert C Ludolph, Christoph Münch

  • 1Department of Neurology, Charité Hospital, Humboldt University, Augustenburger Platz 1, 13353 Berlin, Germany. thomas.meyer@charite.de

Journal of the Neurological Sciences
|June 27, 2002
PubMed
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Ifosfamide (IFX), an antineoplastic agent, can cause central nervous system (CNS) toxic effects. This case report details a patient experiencing severe negative myoclonus linked to ifosfamide treatment for plasmacytoma.

Area of Science:

  • Neuroscience
  • Oncology
  • Pharmacology

Background:

  • Ifosfamide (IFX) is an antineoplastic agent frequently associated with central nervous system (CNS) toxicity.
  • Neurological symptoms can limit the therapeutic use of ifosfamide.
  • Negative myoclonus, characterized by asterixis, is a recognized but less common CNS side effect.

Observation:

  • A 51-year-old male patient developed severe, disabling negative myoclonus in his extremities after ifosfamide infusion for plasmacytoma.
  • The patient remained awake with no altered mental status; symptoms were present at rest.
  • Cranial MRI and laboratory studies were normal, ruling out structural brain lesions or metabolic abnormalities.

Findings:

  • Electroencephalogram (EEG) revealed continuous, generalized irregular slowing with periodic triphasic waves, indicative of symptomatic encephalopathy.

Related Experiment Videos

  • Discontinuation of ifosfamide led to complete resolution of asterixis within 12 hours.
  • The clinical presentation, normal diagnostic workup, and rapid symptom resolution strongly suggest ifosfamide-induced negative myoclonus.

    • Implications:

    • This case highlights a specific neurological adverse effect of ifosfamide, emphasizing the importance of monitoring for CNS toxicity.
    • Early recognition and discontinuation of ifosfamide may prevent prolonged or severe neurological impairment.
    • Further research into the mechanisms of ifosfamide neurotoxicity is warranted to develop preventative or therapeutic strategies.