Bilateral facial nerve palsy secondary to the administration of high-dose paclitaxel

Bilateral facial nerve palsy is an uncommon occurrence. We describe a case of bilateral facial nerve palsy secondary to a single cycle of high-dose pa clitaxel therapy (825 mg/m(2)), in a woman with breast cancer. Prior to her high-dose therapy, she had a residual grade 2 peripheral neuropathy follow ing treatment with ten cycles of standard-dose paclitaxel (total dose 3200 mg). The features of the peripheral neuropathy due to standard-dose paclita xel, which can be both motor and sensory, are well described. Cumulative pa clitaxel dose is considered a risk factor for development of the neuropathy . Although facial nerve palsy secondary to paclitaxel is not previously rep orted, other cranial nerve toxicity has been described. Consistent with rep orts of the reversibility of paclitaxel-induced peripheral neuropathy, the facial nerve palsies in our patient resolved over 23 months. Ongoing studie s of high-dose paclitaxel warrant close attention to its cumulative neuroto xic effects, particularly in patients previously treated with neurotoxic ch emotherapy.