Medication-induced exacerbation of neuropathy in Charcot Marie Tooth Disease

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J Neurol Sci. 2005 Dec 27

Medication-induced exacerbation of neuropathy in Charcot Marie Tooth

Disease.

Weimer LH, Podwall D.

Department of Neurology, Columbia University College of Physicians

and Surgeons, The Neurological Institute, 710 West 168th Street, Unit

55, New York, NY 10032, USA.

Toxin or medication-induced worsening of preexisting peripheral

neuropathy is a generally accepted but not well-studied phenomenon in

humans. Drug-induced exacerbation of Charcot Marie Tooth disease

(CMT) neuropathy is a common concern; a list of potential drugs to

avoid is maintained by the CMT Association but with limited direct

evidence or advice on relative risk. An extensive literature search

for reported cases of drug effects in CMT patients found the vast

majority concerned excessive vincristine toxicity in patients with

undiagnosed demyelinating forms of CMT, many after 1 or 2 doses. The

CMT North American database was also queried for all drug-related

effects. All but one drug cited as worsening neuropathy was present

on a compiled inclusive list. These results and other available

evidence were used to develop a revised risk stratified list for CMT

patients and clinicians to consult prior to discussing risk to

benefit ratios and making treatment decisions.