Talebian Ahmad, Goudarzi Razieh Moazam, Mohammadzadeh Mahdi, Mirzadeh Azadeh Sadat
Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran ; Department of Pediatrics, Kashan University of Medical Sciences, Kashan, Iran.
Department of Pediatrics, Kashan University of Medical Sciences, Kashan, Iran.
Iran J Child Neurol. 2014 Winter;8(1):66-8.
Vincristine (VCR) is a vinca alkaloid that is used for treatment of many malignancies. The vinca alkaloids are neurotoxic, usually causing a peripheral neuropathy, but cranial neuropathies are rare as side effects. Described here is the case of a 2.5-year-old boy, a known case of Wilms' tumor, treated by vincristine (0.067 mg/kg/day) and dactinomycin (0.045 mg/kg/day) after surgery. Three weeks after treatment, he presented with bilateral ptosis. Neurological examination revealed bilateral ptosis with normal pupillary reflex and eye movement. He received 3.015 mg cumulative dose of vincristine before development of ptosis. Treatment with pyridoxine (150 mg/m2 p.o. BID) and pyridostigmine (3 mg/kg p.o. BID) was started as neuroprotective agents, and after 7 days the problem disappeared. The treatment continued for 6 weeks and there were no signs of ptosis or a recurrence in follow up 2 months later.
长春新碱（VCR）是一种长春花生物碱，用于治疗多种恶性肿瘤。长春花生物碱具有神经毒性，通常会导致周围神经病变，但作为副作用出现的颅神经病变很少见。本文描述了一名2.5岁男孩的病例，该男孩为已知的肾母细胞瘤患者，术后接受长春新碱（0.067mg/kg/天）和放线菌素D（0.045mg/kg/天）治疗。治疗三周后，他出现双侧上睑下垂。神经系统检查显示双侧上睑下垂，瞳孔反射和眼球运动正常。在出现上睑下垂之前，他接受的长春新碱累积剂量为3.015mg。开始使用维生素B6（150mg/m²口服，每日两次）和吡啶斯的明（3mg/kg口服，每日两次）作为神经保护剂进行治疗，7天后问题消失。治疗持续了6周，2个月后的随访中没有上睑下垂或复发的迹象。
