Abstract

Sinan Akbayram, Fesih Aktar, Murat Do�?an, Cihangir Akgün , Mustafa Izmirli , Hüseyin �?aksen , AhmetFaik Oner

This report describes the successful management of vincristine-induced unilateral ptosis with pyridoxine and pyridostigmine in a three year old girl with Stage 2a Wilms tumor. Vincristine as an antineoplastic drug causes neurotoxicity frequently. We report here about a 3-year-old girl having a vincristine-induced cranial polyneuropathy and a complete remission due to the therapy with pyridoxine and pyridostigmine. The 3- year-old girl was diagnosed with a Wilms tumor. Following nephroureterectomy she was treated with four cycles of actinomycin D (250 mg/m2 ), six cycles of adriamycine (20 mg/m2 ), six cycles of etoposide (100 mg/m2 ) and nine cycles of vincristine sulphate (1.4 mg/m2 ). One day after the last vincristine sulphate treatment, she developed unilateral ptosis without pupillary or other oculomotor dysfunction. A neuroprotective and neuroregenerative treatment of this vincristine-induced cranial neuropathy was attempted with pyridoxine (150 mg/m2 /dayper oral bid) and pyridostigmine (3 mg/kg/dayper oral bid). The unilateral ptosis markedly improved after two weeks of pyridoxine and pyridostigmine treatment and completely resolved after 4 weeks.