Childhood Thalidomide Neuropathy: A Clinical and Neurophysiologic Study

Thalidomide for inflammatory bowel disease

“…On the opposite, as reported in studies in multiple myeloma patients or in other inflammatory diseases, [46–49] peripheral neuropathy is generally detected after several months of treatment, as it seems to be associated more with thalidomide cumulative dose, rather than with the daily dosage. The frequency of thalidomide-induced peripheral neuropathy varies in the current literature depending on the age of patients, the primary disease, the drug doses, the concomitant treatments, and the length of follow-up.…”

“…[47] Data for children are limited: Priolo and colleagues evaluated 13 patients treated with thalidomide for rheumatological conditions or for Crohn's disease and found a clinical neuropathy in 35.8% of cases and the presence of electromyographic subclinical alterations in 53.8% of cases. [49] Thalidomide-induced peripheral neuropathy is a predominantly sensory polyneuropathy affecting mainly long and large fibers; [39,49,50] it has been described as reversible although few cases presented persistent clinical and electrophysiologic alterations after thalidomide suspension during a short follow-up time. [49] Nerve conduction studies are useful to monitor the development and the evolution of neurotoxicity once it has become clinically apparent, although it is not fully clear if electromyographic abnormalities in the absence of symptoms are predictive of a developing clinical neuropathy.…”

“…[49] Thalidomide-induced peripheral neuropathy is a predominantly sensory polyneuropathy affecting mainly long and large fibers; [39,49,50] it has been described as reversible although few cases presented persistent clinical and electrophysiologic alterations after thalidomide suspension during a short follow-up time. [49] Nerve conduction studies are useful to monitor the development and the evolution of neurotoxicity once it has become clinically apparent, although it is not fully clear if electromyographic abnormalities in the absence of symptoms are predictive of a developing clinical neuropathy. [45] While awaiting further safety data in patients treated with IBD with low doses of thalidomide, it remains important to warn patients of the need to report symptoms suggestive of neuropathy (tremors, numbness and tingling), and to perform careful routine neurological evaluations including sensitivity to vibration.…”

Inflammatory bowel disease in Chinese children: A retrospective analysis of 49 cases

“…The side effects of thalidomide, including peripheral neuropathy, drowsiness, fatigue, constipation, xerosis cutis and granulocytopenia, were tolerable for patients during the follow-up period in the current study, and no severe neurotoxicity was observed. Due to the irreversible neurotoxicity with a dose-and time-dependent manner, the clinical application of thalidomide treatment is limited and nerve conduction velocity tests should be performed during follow-up examinations (43).…”

Clinical Cases in Pediatric Peripheral Neuropathy

“…Stopping this chemotherapeutic agent does not necessarily lead to resolution of CIN symptoms. In one study, after 4-6 years post cessation of Thalidomide, in those patients that had its associated neuropathy, only 25% had recovered completely (Strauss, 2000;Priolo, 2008). There is no cure for CIN.…”