Without ENMG, detecting pediatric vincristine neuropathy is a challenge

Kreeta Viinikainen, Pirjo Isohanni, Jukka Kanerva, Tuula Lönnqvist, Leena Lauronen

Research output: Contribution to journalArticleScientificpeer-review


Objective: Vincristine, a widely used anticancer chemotherapy drug, may cause polyneuropathy (PNP), potentially resulting in permanent functional impairment. We characterized the occurrence and development of vincristine-induced neuropathy (VIPN) in early treatment of childhood leukemia. Methods: This prospective study of 35 pediatric acute lymphoblastic leukemia (ALL) patients comprised systematic clinical and electrophysiological studies at both the time of diagnosis and at least one time point during the first months of treatment. Results: After vincristine treatment, all patients had axonal sensorimotor PNP on electroneuromyography (ENMG) In 34/35 patients, the motor and in 24/35 the sensory responses were decreased. Interestingly, in 3 patients PNP was most prominent in the upper limb. However, some children had no PNP symptoms despite moderate ENMG findings, and not all clinical symptoms were correlated with abnormal ENMG. Conclusions: Pediatric VIPN is a sensorimotor, predominantly motor axonal neuropathy. VIPN can be detected even in its early phase by ENMG, but it is difficult to detect by symptoms and clinical examination only. Significance: Pediatric ALL patients treated with vincristine are at risk of developing VIPN. Since the clinical signs of PNP in acutely ill children are difficult to identify, VIPN can easily be overlooked if ENMG is not performed.

Original languageEnglish
JournalClinical neurophysiology practice
Pages (from-to)94-101
Number of pages8
Publication statusPublished - Jan 2024
MoE publication typeA1 Journal article-refereed

Bibliographical note

Publisher Copyright:
© 2024 International Federation of Clinical Neurophysiology

Fields of Science

  • ALL
  • Child
  • ENMG
  • Polyneuropathy
  • Sensorimotor
  • Vincristine
  • 3123 Gynaecology and paediatrics

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