Chemotherapy induced peripheral neuropathy - CIPN

Question 1

58F - difficulty walking
last several weeks - bilateral foot numbness + tingling
Dx with hoghkin lymphoma
undergoing chemotherapy - bleomycin + doxorubicin + vincristine
DM + HTN bilateral weakness on dorsiflextion of the feet
knee jerk = 2+
ankle jerk = absent

Dx ?????

Answer 1

chemotherapy induced peripheral neuropathy - CIPN

Question 2

Causative agents of CIPN ?

Answer 2

platinum based drugs - cisplatin
taxans - paclitaxel
vinca alkaloids - vincristine

Question 3

features of CIPN ?

Answer 3

Paresthesia in the fingers and toes - stocking glove pattern - early loss of ankle jerks - loss of pain and T sensation

Question 4

Hodgkin lymphoma may result in ??

Answer 4

spinal cord compression

Question 5

spinal cord compression features ?

Answer 5

local back pain
pain worse at night
lower extremity wekaness
absent/hypoactive deep tendon reflex
dec rectal sphincter tone
bilateral bainski reflex

Question 6

if it was tabes drosalis what will be the features there ?

Answer 6

pupillary irregularities - argyll robertson pupil