Obstet Gynecol Sci.  2018 May;61(3):421-424. 10.5468/ogs.2018.61.3.421.

Non-convulsive seizure related to Cremophor ELâ„¢-free, polymeric micelle formulation of paclitaxel: a case report

Affiliations
  • 1Department of Obstetrics and Gynecology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea. nwlee@korea.ac.kr

Abstract

Paclitaxel is a chemotherapeutic agent that is effective against ovarian, breast, lung, and other cancers. Although peripheral neurotoxicity is among the most common side effects of paclitaxel treatment, central neurotoxicity is rarely reported. When centrally mediated side effects are observed, they are attributed to Cremophor ELâ„¢ (CrEL), a surfactant-containing vehicle used for paclitaxel administration. In the present report, we discuss the case of a 72-year-old woman with ovarian carcinoma who experienced a non-convulsive seizure following administration of a CrEL-free, polymeric micelle formulation of paclitaxel. One week after her fourth round of chemotherapy, she experienced a transient episode of aphasia for 45 minutes. Electroencephalography demonstrated epileptiform discharges. To our knowledge, this is the first reported case of seizure associated with a CrEL-free formulation of paclitaxel. Although rare, patients and clinicians should remain aware of the risk of non-convulsive seizure following infusion of this paclitaxel formulation.

Keyword

Paclitaxel; Seizures; Neurotoxicity; Cremophor

MeSH Terms

Aged
Aphasia
Breast
Drug Therapy
Electroencephalography
Female
Humans
Lung
Paclitaxel*
Polymers*
Seizures*
Paclitaxel
Polymers

Figure

  • Fig. 1 Initial electroencephalogram showing frequent spikes arising from the left temporal area.

  • Fig. 2 Electroencephalogram performed 4 days following seizure and discontinuation of treatment, showing no epileptiform discharges.


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