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Thalidomide neuropathy in childhood.
Fiona J Fleming1, Michal Vytopil, Jeffrey Chaitow
1Institute for Neuromuscular Research, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, Sydney 2145, NSW, Australia.
Neuromuscular Disorders : NMD
|February 8, 2005
Summary
Thalidomide reintroduction for various conditions carries a risk of sensorimotor axonal neuropathy in children. Regular neurophysiologic monitoring is crucial to detect this potentially progressive side effect.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
- Toxicology
Background:
- Thalidomide, withdrawn in 1961 due to teratogenicity, is now used for dermatologic, immunologic, rheumatologic, and neoplastic disorders.
- Peripheral neuropathy is a recognized, dose-limiting side effect of thalidomide therapy.
Observation:
- This report details four pediatric cases (ages 10-15) experiencing sensorimotor axonal neuropathy.
- Indications for thalidomide treatment included myxopapillary ependymoma, Crohn's disease, and recurrent giant aphthous ulceration.
Findings:
- Thalidomide-induced neuropathy in children can manifest as proximal weakness.
- The neuropathy may progress even after thalidomide cessation, a phenomenon termed 'coasting'.
Implications:
- Children receiving thalidomide require vigilant monitoring for peripheral neuropathy.
- Regular neurophysiologic studies are recommended to identify presymptomatic or progressive neuropathy in pediatric patients.