Fulminant peripheral neuropathy with severe quadriparesis associated with vincristine therapy

Objective. To report a case of fulminant neuropathy with severe quadripares is associated with vincristine chemotherapy. CASE SUMMARY: A 48-year-old white man with acute lymphoblastic leukemia was started on an induction chemotherapeutic regimen that included intravenous vincristine. He received a total of 6 mg of vincristine over two weeks dur ing induction chemotherapy. Over the next two weeks, he developed a fulmina nt peripheral neuropathy with severe quadriparesis. Discussion: Although commonly associated with peripheral neuropathy, vincri stine neurotoxicity only rarely involves instances of fulminant peripheral neuropathy with severe quadriparesis. Guillain-Barre syndrome is also assoc iated with leukemia and may present as a fulminant peripheral neuropathy wi th severe quadriparesis. Conclusion Fulminanant neuropathy with severe quadriparesis occurring in pa tients with leukemia being treated with vincristine (and who do not have co existent Charcot-Marie-Tooth disease) is more likely due to Guillain-Barre syndrome than to vincristine neurotoxicity.