Aggravated Carpal Tunnel Syndrome after Paclitaxel Chemotherapy without Development of Peripheral Polyneuropathy - A Case Report -

Case Report

J Korean Assoc EMG Electrodiagn Med 2015;17(1):25-30.
Published online June 30, 2015.

Received: 19 December 2014 • Revised: 26 February 2015 • Accepted: 26 February 2015

Abstract

Functionally disabling peripheral neuropathy is a major side effect of many chemotherapeutic agents. Chemotherapy (CTx) commonly induces distal, symmetric peripheral polyneuropathy (PPNP), for which there is no specific treatment. We report a case in which paclitaxel-based CTx did not induce PPNP but instead aggravated the pre-existing carpal tunnel syndrome (CTS), which improved after surgical decompression. Because subclinical entrapment neuropathy is not uncommon, we suggest evaluating the pre-existing neuropathy before starting CTx. If a focal entrapment neuropathy, including CTS, is found, patients should be warned of the possibilities of belated aggravation of such neuropathies with CTx, and if possible, regular follow-up with nerve conduction studies and needle electromyography should be performed for early diagnosis. Furthermore, because prompt surgical correction is likely to improve the cases of aggravated CTS and possibly other focal entrapment neuropathies, early diagnosis and immediate intervention will lead to better functional outcomes.

Key Words: carpal tunnel syndrome, paclitaxel, polyneuropathies