Oxaliplatin-Induced Tonic-Clonic Seizures

Area of Science:

• Oncology
• Neuroscience
• Pharmacology

Background:

• Oxaliplatin is a platinum-based chemotherapy agent widely used for colorectal and gastric cancers.
• Common side effects include peripheral neuropathy and hematological toxicity; seizures are a rare adverse event, typically linked to Posterior Reversible Encephalopathy Syndrome (PRES).
• This case examines seizures occurring in the absence of PRES.

Purpose of the Study:

• To report a rare case of tonic-clonic seizures associated with oxaliplatin chemotherapy.
• To investigate the potential link between oxaliplatin and seizures independent of PRES.
• To contribute to the understanding of rare neurological adverse events in cancer therapy.

Main Methods:

• A case study of a 50-year-old male patient diagnosed with mixed adenoneuroendocrine carcinoma.
• The patient received adjuvant chemotherapy with FOLFOX (Folinic acid, Fluorouracil, Oxaliplatin).
• Neurological events were monitored, and diagnostic tests including EEG and MRI were performed; rechallenge with oxaliplatin was conducted.

Main Results:

• The patient experienced recurrent tonic-clonic seizures during the third cycle of FOLFOX.
• Standard laboratory workup, EEG, and brain MRI showed no abnormalities.
• Seizures recurred upon rechallenge with oxaliplatin, and resolved after switching to FOLFIRI (Folinic acid, Fluorouracil, Irinotecan).

Conclusions:

• Oxaliplatin was identified as the probable cause of the patient's tonic-clonic seizures.
• This case underscores the possibility of oxaliplatin-induced seizures occurring independently of PRES.
• Further investigation into the mechanisms of oxaliplatin neurotoxicity is warranted.