|
| Authors | Patient
(age, sex) | Localization | Chemotherapy | Symptoms | MRI | Treatment | Outcomes |
|
|
Sawaya et al., 2014 [18] | 31 W | Ovarian carcinoma | Bevacizumab | Focal tonic-clonic
seizure
BP: not mentioned | Cortical and subcortical lesions of
the parietal, occipital, and frontal lobes, posterior fossa, left pons, left cerebral peduncle | Intravenous benzodiazepines,
phenytoin, and valproic acid | The patient recovered slowly over a fortnight |
|
| Dersch et al., 2013 [19] | 41 W | Lung cancer | Gemcitabine-cisplatin Bevacizumab | Grand mal seizures, nausea, vomiting, limb ataxia, visual hallucinations, confusion, headache
BP: 180/110 mmHg at admittance with peaks to 245/140 mmHg | Bifrontal, parietal, temporal, thalamic, and cerebellar laminar T2-hyperintensive lesions | — | — |
|
| Lazarus et al., 2012 [20] | 72 M | Lung cancer | Maintenance Bevacizumab (patient received paclitaxel-carboplatin and Bevacizumab before) | Emesis, aphasia, altered mental status, agitation,
myoclonus, tonic-clonic seizures,
BP: 164/75 | Bilateral cortical hyperintensities, involving the occipital lobes and cerebellar hemispheres | Enoxaparin | Worsening of lesions
patient died |
|
|
Lau and Paunipagar, 2011 [21] | 63 W | Metastatic
rectosigmoid
carcinoma | Intravenous Bevacizumab in
combination with oxaliplatin
and 5-fluorouracil | Headache, drowsiness, visual disturbance,
no focal neurological signs in the limbs
vital signs were stable (BP: not mentioned) | Complete spontaneous clinical recovery
within 1 week | Supportive
measures | Signal abnormalities in the subcortical white matter
in the posteroinferior parietotemporal lobes |
|
|
Seet and Rabinstein, 2012 [17] | 68 W | Metastatic non-small
cell lung carcinoma | Intravenous Bevacizumab in
combination with taxol and
carboplatin | Headaches, confusion,
nausea, and vomiting
BP 221/84 mmHg | Cerebellar lesions
on MRI brain | Intravenous labetatol | Neurologic recovery
one day later
MRI changes resolved
8 days later |
|
|
Seet and Rabinstein, 2012 [17] | 63 W | Advanced pancreatic
carcinoma | Intravenous Bevacizumab in
combination with gemcitabine
and oxaliplatin | Seizures and cortical blindness
BP 190/94 mmHg | Parietooccipital
lesions on
MRI brain | Oral
antihypertensive
medications | Neurologic recovery
4 days later
MRI changes resolved
30 days later |
|
|
Levy et al., 2009 [22] | 4 M | Hepatoblastoma | Intravenous Bevacizumab in
combination with gemcitabine
and oxaliplatin | Seizures, headache,
BP: 160/120 mmHg | Frontal and
parietooccipital
subcortical lesions
on MRI brain | Antihypertensive
medications (details not mentioned) | Neurologic deficits
resolved 13 days
later
MRI changes resolved 21 days later |
|
|
Bürki et al., 2008 [23] | 33 W | Metastatic breast
cancer | Intravenous Bevacizumab in
combination with
liposomal doxorubicin | Headaches, gastralgia, nausea, and vomiting.
BP: 150/100 mmHg. | Frontal and
parietooccipital
subcortical lesions
on MRI brain | Intravenous infusion of prednisolone, furosemide,
nicardipine,
and mannitol | Neurologic recovery
1 day later
MRI changes resolved
4 days later |
|
|
El Maalouf et al., 2008 [24] | 55-year-old woman | Metastatic colon
cancer | Intravenous Bevacizumab in
combination with fluorouracil
and leucovorin | Lethargy, dysarthria, and
generalized seizures
BP 190/120 mmHg | Pontomedullary
lesions on MRI
brain | Oral amlodipine | Neurologic deficits
resolved 1 day later
MRI changes resolved
21 days later |
|
| Koopman et al., 2008 [25] | 49 M | Colorectal
cancer | Intravenous Bevacizumab in
combination with oxaliplatin
and capecitabine | Unconsciousness, seizures,
and urinary incontinence
BP 180/100 mmHg | Occipital lesions
on CT brain | Antihypertensive
medications (details
not
mentioned) | Neurologic deficits
resolved 2 days
later
CT brain changes
resolved 6 weeks
later |
|
| Peter et al., 2008 [26] | 57 W | Metastatic
colon carcinoma | Folfox regimen + intravenous Bevacizumab | Cortical blindness
BP 140/70 mmHg | Parietooccipital
subcortical lesions
on MRI brain | No
antihypertensive medications
administered | Neurologic deficits
recovered 4 weeks
later
MRI brain resolved
7 weeks later |
|
| Ozcan et al., 2006 [27] | 52 W | Metastatic rectal
adenocarcinoma | Folfox regimen + intravenous Bevacizumab | Headaches, confusion, and
cortical blindness
BP 172/100 mmHg | Occipital subcortical
lesions on MRI
brain | Antihypertensive
medications
(details not
mentioned) | Neurologic recovery
3 days later
Radiologic resolution
not mentioned |
|
| Allen et al., 2006 [28] | 52 M | Metastatic rectal
carcinoma | FOLFIRI regimen + intravenous Bevacizumab | Headaches, bilateral cortical
blindness, confusion, agitation,
generalized tonic-clonic
seizure.
Systolic BP range 140–150 mmHg | Occipital and posterior
parietal lobes
subcortical lesions
on MRI brain | Corticosteroids | Neurologic deficits
recovered 25 days
later |
|
| Glusker et al., 2006 [29] | 59 W | Renal cancer | Bevacizumab | Severe lethargy.
Blood pressure: 168/88 mmHg
cortical blindness
extensor plantar responses | Frontal and parietooccipital
subcortical lesions
on MRI brain | Lorazepam
No medication
for hypertension | Return to normal without treatment 4 days later
Complete resolution
of the leucoencephalopathy on MRI six weeks later |
|
| Our case | 44 W | Metastatic colon cancer | Folfox + Bevacizumab | Delirium, seizures, visual disturbance, focusing signs
BP: 170/90 mmHg | Frontoparietooccipital lesions on brain CT | Intravenous nicardipine
Oral phenobarbital | Complete neurologic recovery |
|
