Spinal cord toxicity complicating treatment with cisplatin and etoposide

Neurologic toxicity occurring in patients treated with cisplatin chemotherapy is limited primarily to peripheral neuropathy and ototoxicity. Lhermitte's sign, electric-like paresthesias precipitated by cervical spine flexion, has recently been described as a self-limited complication in cisplatin-treated patients. We report the development of Lhermitte's sign accompanied by cervical motor neuropathy, dorsal column myelopathy, and sensory neuropathy in a patient treated with cisplatin and etoposide for small cell lung cancer. Persistence of the neurologic deficit suggests that potentially irreversible spinal cord toxicity may complicate treatment with this chemotherapy combination.