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卡铂和紫杉醇治疗导致的可逆性后部白质脑病综合征

Reversible Posterior Leukoencephalopathy Syndrome Due to Carboplatin and Paclitaxel Therapy.

作者信息

Kandemir Melek, Küçükkaya Belgin, Tepe Muzaffer Savaş, Yalçıner Zehra Betül, Salepçi Nedret Taflan

机构信息

Department of Neurology, Bayındır Hospital İçerenköy, İstanbul, Turkey.

Department of Internal Medicine, Bayındır Hospital İçerenköy, İstanbul, Turkey.

出版信息

Balkan Med J. 2015 Oct;32(4):421-5. doi: 10.5152/balkanmedj.2015.15487. Epub 2015 Oct 1.

Abstract

BACKGROUND

Reversible posterior leukoencephalopathy syndrome (RPLS) is a clinicoradiologic syndrome characterized by headache, decreased alertness, seizures, visual abnormalities, and white matter changes indicative of cerebral edema. Although the pathogenesis remains poorly understood, several etiological causes have been described. RPLS is a common complication of chemotherapeutics because of its toxic effect on the central nervous system. This syndrome is frequently associated with seizures but rarely seen with status epilepticus and periodic lateralized epileptiform discharges (PLEDs).

CASE REPORT

We present a case with metastatic lung cancer that developed RPLS after carboplatin and paclitaxel therapy. Our case was admitted to the hospital with status epilepticus and her electroencephalography showed PLEDs.

CONCLUSION

It is important to closely monitor blood pressure and electrolyte levels in patients who take chemotherapeutic agents, especially when there is no previous history of hypertension. It should be kept in mind that RPLS is a causative factor of status epilepticus and PLEDs.

摘要

背景

可逆性后部白质脑病综合征(RPLS)是一种临床影像学综合征,其特征为头痛、意识水平下降、癫痫发作、视觉异常以及提示脑水肿的白质改变。尽管其发病机制仍不清楚,但已有多种病因被描述。由于对中枢神经系统有毒性作用,RPLS是化疗药物的常见并发症。该综合征常与癫痫发作相关,但癫痫持续状态和周期性一侧性癫痫样放电(PLEDs)较少见。

病例报告

我们报告一例转移性肺癌患者,在接受卡铂和紫杉醇治疗后发生了RPLS。该病例因癫痫持续状态入院,脑电图显示有PLEDs。

结论

对于接受化疗药物治疗的患者,尤其是既往无高血压病史的患者,密切监测血压和电解质水平很重要。应记住RPLS是癫痫持续状态和PLEDs的一个致病因素。

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