Ifosfamide neurotoxicity: An atypical presentation with psychiatric manifestations

Abstract

Ifosfamide can be responsible for acute central neurotoxicity in children and adolescents treated for cancer. The signs of acute encephalopathy most frequently observed are: alteration of consciousness, cerebellar syndrome, asthenia, urinary incontinence, cranial nerve palsy, and seizures. Various combinations of these signs may occur, but disorders of consciousness and drowsiness are common. We describe the case of a young man presenting with reversible acute hypomanic disorder during ifosfamide-based chemotherapy and discuss the possible mechanisms of this toxicity.

The glycine deportation system and its pharmacological consequences

“…In the intervening years, there have been numerous reports of ifosfamide encephalopathy. This life-threatening drug effect has been estimated to occur with an incidence from <5% to >70% (Tajino et al, 2010), with a typical occurrence of 10–30% in adult patients (Liu et al, 2010; Ryan et al, 2008; Savica et al, 2011; Tajino et al, 2010) and 3–19% in pediatric patients (Ames et al, 2010; Kerdudo et al, 2006). Other types of neurotoxicity, particularly transient seizures, have been reported in ~5% children receiving IFO for solid tumors or leukemia (Di Cataldo et al, 2009).…”

Trouble bipolaire et cancer : particularités de la prise en charge

“…L'ifosfamide est connu pour sa neurotoxicité (en particulier un risque d'encéphalopathie), des effets toxiques sur le rein et des cystites hémorragiques. Deux épisodes maniaques sous ifosfamide ont été décrits chez deux adolescents sans antécédent psychiatrique [7,18].…”

Ifosfamide neuropsychiatric toxicity in patients with cancer

“…Ifosfamide use has been associated with central nervous system (CNS) toxicity in 5-30% of patients. Neuropsychiatric toxicity has been poorly defined in pediatric population despite its extensive use in childhood cancers, the incidence ranges from less than 3 to 19% reported by different authors [2].…”

“…Ifosfamide neuropsychiatric toxicity, commonly known as ifosfamide neurotoxicity or encephalopathy, is a challenging problem, occurring in 5-30% of patients with cancer. Clinical symptoms may range from mild confusion to stupor, coma and death [2]. This is a case report describing an unusual manifestation of ifosfamide toxicity, a psychotic disorder with delusions.…”