tailieunhanh - Báo cáo y học: " Transient bilateral abducens neuropathy with post-tetanic facilitation and acute hypokalemia associated with oxaliplatin: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Transient bilateral abducens neuropathy with post-tetanic facilitation and acute hypokalemia associated with oxaliplatin: a case report | Tan et al. Journal of Medical Case Reports 2010 4 36 http content 4 1 36 jAg JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Transient bilateral abducens neuropathy with post-tetanic facilitation and acute hypokalemia associated with oxaliplatin a case report Min-Han Tan1 2 Wen Yee Chay1 Jia Hui Ng1 Bin Tean Teh2 Lita Chew3 Abstract Introduction Oxaliplatin is a cytotoxic platinum compound that is in widespread use in the treatment of gastrointestinal cancers. It has been occasionally associated with acute motor neuropathy but the precise mechanism is uncertain. To the best of our knowledge we report the first case of a patient demonstrating post-tetanic facilitation in the setting of transient bilateral abducens neuropathy and hypokalemia after being infused with oxaliplatin. Case presentation A 47-year-old Indian woman with metastatic gastric cancer was receiving an oxaliplatin infusion at the initiation of her third cycle of palliative chemotherapy. She developed acute bilateral abducens neuropathy with post-tetanic facilitation alongside acute laryngopharyngodysesthesia and hypokalemia. Following supportive management including potassium infusion and warming her neurological signs and symptoms were spontaneously resolved. This syndrome did not recur in subsequent cycles following prolongation of infusion duration and the addition of supportive calcium and magnesium infusions. Conclusion The novel clinical observation of post-tetanic facilitation highlights a possible involvement of voltagegated channels at the presynaptic terminals in the mechanism of acute oxaliplatin neurotoxicity. Introduction Oxaliplatin is a recently developed cytotoxic platinum compound that is in widespread use particularly for the treatment of gastrointestinal cancers 1 . The association between oxaliplatin and acute and chronic sensory neuropathy is well recognized but acute motor neuropathy is also reported albeit much less frequently 2 . The .