Abstract
IntroductionChemotherapy related encephalopathy is commonly reported with certain forms of chemotherapy but few reports note an association with low dose 5-Fluorouracil.Case presentationA 57-year-old Caucasian lady received her first cycle of Cisplatin and 5-Fluorouracil for palliative treatment of cervical carcinoma, and presented several days later with signs of encephalopathy. Several causes were eliminated, and encephalopathy related to 5-Fluorouracil was thought to be the most likely cause. Magnetic Resonance Imaging of the head revealed changes related to the chemotherapy received. Symptoms resolved completely within three days of presentation.ConclusionEncephalopathy from low dose 5-Fluorouracil is not well documented in the literature. Fluid rehydration and supportive treatment is required. Signs and symptoms resolved completely with no residual effects on follow up.
Highlights
Introduction: Chemotherapy related encephalopathy is commonly reported with certain forms of chemotherapy but few reports note an association with low dose 5-Fluorouracil
Case presentation: A 57-year-old Caucasian lady received her first cycle of Cisplatin and 5-Fluorouracil for palliative treatment of cervical carcinoma, and presented several days later with signs of encephalopathy
Case presentation A 57-year-old Caucasian lady was admitted to hospital feeling generally unwell with nausea, lethargy and reduced appetite
Summary
Certain types of chemotherapy are more commonly associated with neurotoxic side effects, most commonly Ifosfamide and Methotrexate [1]. Case presentation A 57-year-old Caucasian lady was admitted to hospital feeling generally unwell with nausea, lethargy and reduced appetite She had been unwell since discharge from hospital two weeks ago after her first in-patient cycle of Cisplatin and 5-Fluorouracil (5-FU). Later the same day and into the early hours of the morning, her confusion returned and she became incontinent of urine She no longer communicated with staff verbally, and repetitive actions, such as licking her lips and moving her hand round in circles, were observed. The Neurology team were asked to advise and their differential diagnosis consisted of non convulsive status, acute mal encephalitis, paraneoplastic limbic encephalitis, drug related encephalopathy, sinus vein thrombosis or infectious encephalitis They suggested the following further investigations; MRI brain, to exclude temporal lobe inflammation, lumbar puncture, to assess for infection or neoplastic infiltration, and an EEG. The MRI concluded that there were small amounts of non-enhancing white matter change in the parietal lobes (Figure 1 and Figure 2)
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