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Misonidazole neuropathy.

O B Paulson, B Melgaard, H S Hansen

    Acta Neurologica Scandinavica. Supplementum
    |January 1, 1984
    PubMed
    Summary
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    Misonidazole treatment can cause neurotoxic side effects, specifically peripheral neuropathy. This study found a significant increase in neuropathy cases among patients receiving misonidazole compared to placebo.

    Area of Science:

    • Oncology
    • Neuroscience
    • Pharmacology

    Background:

    • Misonidazole is a hypoxic cell radiosensitizer used in cancer therapy.
    • Peripheral neuropathy is a potential neurotoxic side effect of various treatments.

    Purpose of the Study:

    • To investigate the neurotoxic side effects of misonidazole, focusing on peripheral neuropathy.
    • To determine the incidence of peripheral neuropathy in patients treated with misonidazole.

    Main Methods:

    • Two series of patients were studied: one with existing neuropathy during misonidazole treatment, and another comparing misonidazole with placebo during radiotherapy.
    • Clinical evaluation, electrophysiological studies, and histological examination were used to assess neuropathy.
    • Statistical analysis was performed to compare neuropathy incidence between misonidazole and placebo groups.

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    Main Results:

    • In the first series, eight patients developed sensory peripheral neuropathy, characterized by axonal damage and demyelination, which partially resolved after treatment cessation.
    • In the second series, 38% of patients receiving misonidazole developed peripheral polyneuropathy compared to only 6% in the placebo group.
    • Neuropathy primarily affected the lower extremities, particularly the feet.

    Conclusions:

    • Misonidazole is associated with a significant risk of developing peripheral neuropathy.
    • The neuropathy appears to be an axonal type with secondary demyelination.
    • Clinical monitoring for neurotoxic effects is recommended during misonidazole therapy.