Abstract
Thalidomide was withdrawn from world markets in 1961 following recognition of its teratogenic effects. More recently, however, thalidomide treatment has been reintroduced to adult and paediatric practice for a variety of dermatologic, immunologic, rheumatologic and neoplastic disorders. Neuropathy is a significant side effect of thalidomide therapy, which may limit its clinical use. We report four cases of sensorimotor axonal neuropathy in children aged 10-15 years, treated with thalidomide for myxopapillary ependymoma, Crohn's disease and recurrent giant aphthous ulceration. Thalidomide neuropathy is often associated with proximal weakness and may progress even after discontinuation of treatment, in the phenomenon of 'coasting'. Children treated with thalidomide should undergo regular neurophysiologic studies in order to detect presymptomatic or progressive peripheral neuropathy.
MeSH terms
-
Action Potentials / drug effects
-
Action Potentials / physiology
-
Adolescent
-
Brain Neoplasms / drug therapy
-
Child
-
Crohn Disease / drug therapy
-
Disease Progression
-
Electromyography
-
Ependymoma / drug therapy
-
Gait Disorders, Neurologic / chemically induced*
-
Gait Disorders, Neurologic / pathology
-
Gait Disorders, Neurologic / physiopathology
-
Humans
-
Male
-
Muscle Weakness / chemically induced
-
Muscle Weakness / pathology
-
Muscle Weakness / physiopathology
-
Muscle, Skeletal / innervation
-
Muscle, Skeletal / pathology
-
Muscle, Skeletal / physiopathology
-
Neural Conduction / drug effects
-
Neural Conduction / physiology
-
Neurologic Examination / standards
-
Neurotoxins / adverse effects
-
Peripheral Nerves / drug effects*
-
Peripheral Nerves / pathology
-
Peripheral Nerves / physiopathology
-
Peripheral Nervous System Diseases / chemically induced*
-
Peripheral Nervous System Diseases / pathology
-
Peripheral Nervous System Diseases / physiopathology
-
Thalidomide / adverse effects*
-
Ulcer / drug therapy
-
Withholding Treatment