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Toxic encephalopathy induced by capecitabine.
B Niemann1, C Rochlitz, R Herrmann
1Department of Medical Oncology, Kantonsspital Basel, Basel, Switzerland. bernwardniemann@yahoo.de
Oncology
|June 26, 2004
Summary
Capecitabine can cause toxic encephalopathy, a rare neurological side effect. This case highlights epilepsy-like symptoms and diffuse white matter changes on MRI, expanding on known 5-fluorouracil toxicity.
Area of Science:
- Neuroscience
- Oncology
- Radiology
Background:
- 5-fluorouracil (5-FU) is an antineoplastic agent with known neurotoxic potential.
- Toxic encephalopathy is a rare but serious side effect associated with 5-FU chemotherapy.
- Typical presentations include cerebellar, neuropsychiatric, and focal neurological deficits with patchy white matter changes on MRI.
Observation:
- This report details the first documented case of capecitabine-induced toxic encephalopathy.
- The patient presented with symptoms suggestive of epilepsy.
- Magnetic resonance imaging revealed diffuse white matter alterations.
Findings:
- Capecitabine, a prodrug of 5-FU, can induce toxic encephalopathy.
- The observed neurological symptoms included epilepsy-like manifestations.
- Imaging findings demonstrated diffuse, rather than patchy, white matter alterations.
Implications:
- This case expands the spectrum of known neurotoxic effects of fluoropyrimidine chemotherapy.
- It underscores the importance of considering capecitabine in the differential diagnosis of toxic encephalopathy, especially with atypical MRI findings.
- Further research is warranted to elucidate the mechanisms and prevalence of capecitabine-induced neurotoxicity.