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Thalidomide neuropathy: clinical, electrophysiological and neuroradiological features

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Isoardo G, Bergui M, Durelli L, Barbero P, Boccadoro M, Bertola A, Ciaramitaro P, Palumbo A, Bergamasco B, Cocito D.Thalidomide neuropathy: clinical, electrophysiological and neuroradiological features.

Acta Neurol Scand 2003 DOI: 10.1046/j.1600-0404.2003.00203.x © Blackwell Munksgaard 2003. Objective –

Thalidomide is a promising therapy for multiple myeloma. Sensory neuropathy is a side effect of thalidomide and resulted to be partially reversible in 50% of cases, suggesting a sensory ganglionopathy. Spinal cord magnetic resonance imaging (MRI) was found to be useful in the diagnosis of sensory ganglionopathies and we use it to determine if thalidomide neuropathy has features of a ganglionopathy. Material and methods –

Six patients with multiple myeloma developed thalidomide-induced polyneuropathy. Nerve conduction studies, somatosensory-evoked potentials (SEPs) and cervical and dorsal spinal cord MRI were obtained in all. Results –

All patients had a sensory neuropathy, with clinical or electrophysiological abnormalities involving all four limbs. Spinal cord MRI showed high signal intensity in the posterior columns in only one patient, with abnormal central conduction time at SEPs. Conclusion –

Our results suggest that thalidomide can induce either an axonal length-dependent neuropathy or, less frequently, a ganglionopathy.
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Keywords: multiple myeloma; peripheral neuropathy; sensory ganglionopathy; spinal cord magnetic resonance; thalidomide

Document Type: Research Article

Affiliations: 1: Dipartimento di Neuroscienze, Università di Torino, Torino 2: Dipartimento di Medicina ed Oncologia Sperimentale, sezione di Ematologia, Università di Torino, Torino 3: S.C. Neurochirurgia, Ospedale CTO, Torino

Publication date: 2004-03-01

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