Ifosfamide-related acute encephalopathy: Clinical and radiological aspects

Abstract

IFOSFAMIDE and the uroprotector mesna have been used in the Since only ifosfamide administration was common to all our treatment of various types of malignancies. Side-effects of patients, and the clinical presentation of CNS toxicity in every ifosfamide include nausea and vomiting, myelosuppression, case was similar to previous reports, we related the neurological renal tubular acidosis and renal failure, interstitial pneumonitis, symptomatology to ifosfamide and not to any other drugs. congestive heart failure and central nervous system (CNS) toxicity [l]. In our small group of patients CNS toxicity was observed in 5/18 (28%), 2-7 days following the first day of ifosfamide/mesna administration. The frequency of CNS toxicity ranges from 0% [2] to over 30% [l]. There was a wide spectrum of neurological manifestations in our patients (Table 1). All the patients had evidence of disease progression before ifosfamideimesna was given. None had any symptom of brain metastases or any neurological, mental or cognitive dysfunction, nor did they have any biochemical disturbance before treatment. The two drugs were administered together in 2000 ml NaCl 0.9% per day, by continuous intravenous drip. Metoclopramide (60-120 mg/day), furosemide (40-80 mglday) and KC1 supplement were also given.