Effects of oral isotretinoin therapy on peripheral nerve functions: a preliminary study

Abstract

Accumulating evidence over the past decade indicates that synthetic retinoids may be capable of affecting both growth and differentiation of nervous tissue. Our aim was to substantiate possible side-effects of oral isotretinoin therapy on peripheral nerve functions, both neurologically and neurophysiologically. We performed neurological examination and electroneuromyographic studies on 18 patients with various skin diseases before, at the third month, and at the end of isotretinoin treatment. Abnormal neurophysiological findings in this study point towards a typical distal, length-dependent and predominantly sensory polyneuropathy. Clinicians should be aware of possible neurological sensorial symptoms during isotretinoin therapy. In our opinion, electroneuromyographic investigation should be performed on all patients reporting symptoms (e.g. paresthesia, numbness, sensory loss) before and during oral isotretinoin treatment. The precise clinical significance of the isotretinoin-induced neurophysiological alterations reported here remains to be determined in further studies.

A Case With Bilateral Sacroiliitis and Polyneuropathy Development Due to Isotretinoin Use

“…In another study, sensorial neuropathy was detected in 18 patients treated with systemic isotretinoin (1 mg/kg/day) at the rates of 44% and 83% in electrophysiological evaluations at three and six months, respectively. 6 However, Chroni et al 11 failed to detect clinical or electrophysiological neuropathy in 18 patients treated with systemic isotretinoin (1 mg/kg/day) at one and three months. These differences can be related to duration or dose of isotretinoin use.…”

“…8,10 There is conflicting data in the literature regarding peripheral neuropathy related to isotretinoin use. 6,11,12 In a study by Canpolat et al, 12 no neuropathy was detected by electrophysiological evaluations in 15 patients Figure 1. Magnetic resonance imaging findings during drug use.…”

“…This involvement is more prominent in sensorial nerves and myelin fibers at distal of extremities. 3,6 Deficiency of vitamin B12, diabetes mellitus type I and type II, colchicine, and alcohol use may cause sensorimotor polyneuropathy in distal extremities. 7 The history of the present case was non-specific in terms of these factors.…”

İzotretinoin tedavisinin duysal sinirler üzerine etkileri: Elektromyografik bulgular

“…Bu tür yan etkilerin genellikle santral sinir sistemine olan etkileri nedeniyle görüldüğü düşünülmektedir. Ancak izotretinoinin periferik sinir sistemine olan etkilerini araştıran çalışma sayısı çok az ya da olgu bildirimleri şeklindedir [5][6][7][8][9] . Bu çalışmanın amacı, klinik nörolojik ve elektromiyografik semptom ve bulguları olmayan, nodülokistik akneli hastalarda izotretinoin kullanımının elektromiyografik bulgular üzerine etkisini araştırmaktır.…”

Acne fulminans in the course of oral isotretinoin treatment. Presentation of cases

“…Literature reports single cases in which the commencement of oral isotretinoin treatment is associated with the occurrence of: agranulocytosis, sacroiliac arthritis and demyelinating peripheral neuropathy [3,4], demyelinating lesions within the cerebellum which causes tinnitus and syncopy, foci of cerebral ischemia resulting in facial hemiparesis, Sweet's syndrome, enteritis and pyoderma gangrenosum. Isotretinoin can also cause generalized facial edema as well as affect the patient's psyche by worsening depression symptoms or releasing panic attacks.…”