Chemotherapy-Induced Peripheral Neuropathy — SCE Neurology MCQ

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ModeratePeripheral Neuropathy & NeuromuscularChemotherapy-Induced Peripheral NeuropathySCE Neurology

A 60-year-old woman undergoing chemotherapy develops acute onset of bilateral hand and foot numbness with loss of ankle reflexes. She is on oxaliplatin. NCS show reduced SNAP amplitudes with preserved motor studies and normal conduction velocities. What type of neuropathy has developed?

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Correct answer: A — Pure sensory axonal neuropathy (chemotherapy-induced)

Oxaliplatin is a commonly used chemotherapy agent that causes a dose-dependent sensory axonal neuropathy. It produces two patterns: an acute transient cold-triggered dysaesthesia (within hours of infusion) and a chronic cumulative sensory neuropathy affecting length-dependent large fibre function. NCS show reduced or absent SNAPs with normal motor studies and conduction velocities, confirming a pure sensory axonal process. Other chemotherapy agents causing neuropathy include cisplatin, vincristine, taxanes, and bortezomib. A: Motor studies are normal. C: Autonomic neuropathy has different features. D: The pattern is symmetric, not multifocal. E: MND does not cause sensory changes.

Reference: EAN Chemotherapy-Induced Neuropathy Guidelines (2019)