Protocolo de manejo clínico de la neuropatía en el paciente oncológico

Abstract

IntroductionIt is common for neuropathy to occur in cancer patients. It can appear in the initial phases due to the action of onconeural antibodies in paraneoplastic neurological syndromes, and then in the course of the disease due to infiltration and tumour growth in particular, and as a consequence of chemo and radiotherapy which is the most common cause of neuropathy in these patients. Vinca alkaloids and taxanes, platinum derivatives and thalidomide cause toxicity through various mechanisms (inhibition of axonal transport, damage to the sensitive dorsal lymph node, reversible or otherwise). DiagnosisDiagnosis, essentially by electromyography, enables definition of diffuse neuropathy (with axonal or demyelinating damage to the sensitive or motor components of the nerve) or a focal form. Other techniques (MRI, PET-CT) can complement diagnosis in focal forms. There is pain in 90% of cases due to the action of cytokines and sensitisation of the sympathetic nervous system. TreatmentAlthough few, there are treatment options that include methylcobalamin with acupuncture, alpha-lipoic acid, duloxetine and photomodulation.