Peripheral Nervous System
Cisplatinum Related Neuropathy
Cisplatinum predominantly a sensory peripheral neuropathy with the dorsal root ganglion being the primary target5.
Neuropathy occurs in as many as 75% of patients.
Carboplatinum can also cause peripheral neuropathy (much less likely to cause this than Cisplatinum)3.
Symptoms:
- Paresthesias
- Dysesthesias
- Position and vibration sense disturbed
- Motor units are spared
Investigation:
- Sensory nerve conduction studies show:
- Decrease or absence of sensory nerve action potentials
- Delayed sensory nerve conduction velocities
- Motor nerve conduction and EMG are normal
Risk factors:
- Cumulative dose
- Amofostine has a protective effect on subclinical neurotoxicity when given with cisplatinum.
Prognosis:
- Severe acute neurotoxicity usually resolves
- 20-60% of patients may be left with persistent paresthesias following therapy
