Vincristine-induced polyneuropathy in a child with stage I Wilms' tumour presenting with unilateral abducens nerve palsy

• Main Authors: Panjawatanan P., Charoenkwan P., Katanyuwong K., Choeyprasert W.
• Format: Article
• Language: English
• Published: BMJ Publishing Group 2014
• Online Access: http://www.scopus.com/inward/record.url?eid=2-s2.0-84903643130&partnerID=40&md5=1442b3b3d798ec8ac9dc3ff9cf97c956; http://cmuir.cmu.ac.th/handle/6653943832/1770
• Institution: Chiang Mai University

A 4-year-old boy presented with right esotropia while receiving vincristine and dactinomycin for stage I Wilms' tumour according to the National Wilms Tumour Study-5 protocol. On examination, he had isolated limitation of his right lateral gaze. CT of the brain and cerebrospinal fluid examination were normal. A nerve conduction velocity study which was performed on the peripheral nerves revealed predominant motor polyneuropathy compatible with axonal loss involving the upper limbs. The patient had received a cumulative vincristine dose of 17 mg/m2 before developing esotropia. Vincristineinduced abducens nerve mononeuropathy and subclinical motor polyneuropathy was suspected. Unilateral esotropia markedly improved after the discontinuation of vincristine and a short course of oral pyridoxine treatment. Copyright © 2014 BMJ Publishing Group.