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Ifosfamide extrapyramidal neurotoxicity.

N R Anderson1, D S Tandon

  • 1Cancer Center of Boston, MA 02120.

Cancer
|July 1, 1991
PubMed
Summary
This summary is machine-generated.

Ifosfamide can cause central nervous system toxicity, including encephalopathy and seizures, in 5% to 30% of patients. This case highlights unusual extrapyramidal symptoms as a potential feature of ifosfamide neurotoxicity.

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Area of Science:

  • Oncology
  • Neuropharmacology
  • Toxicology

Background:

  • Ifosfamide is an alkylating agent used in cancer chemotherapy.
  • Central nervous system (CNS) toxicity is a known, albeit variable, side effect of ifosfamide treatment, affecting 5% to 30% of patients.
  • The exact mechanisms underlying ifosfamide-induced neurotoxicity are not fully elucidated but are hypothesized to involve toxic drug metabolites.

Observation:

  • A patient receiving a 5-day course of infused ifosfamide developed neurotoxicity.
  • The neurotoxicity presented with unusual extrapyramidal features, in addition to typical symptoms.
  • Typical symptoms include metabolic encephalopathy, confusion, visual disturbances, mutism, hallucinations, seizures, and coma.

Findings:

  • This case highlights that classic extrapyramidal symptoms can be part of the ifosfamide neurotoxic profile.

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  • The neurotoxicity is hypothesized to result from the accumulation of toxic drug metabolites affecting the CNS.
  • While often reversible upon drug cessation, prolonged or severe neurotoxicity, including death, has been reported.

    • Implications:

    • Clinicians should be vigilant for extrapyramidal symptoms as a potential manifestation of ifosfamide neurotoxicity.
    • Recognition of a broader neurotoxic profile may aid in earlier diagnosis and management of ifosfamide-related CNS adverse events.
    • Further research into the biochemical pathways of ifosfamide neurotoxicity is warranted to improve patient safety.