Electrophysiological and ultra structural study of nerve biopsies from cytotoxic induced peripheral neuropthy in children

ABSTRACT

Forty male children with non-Hodgkin's lymphoma [NHL] were included in this study. Their mean age was 9.83 years +/- 1.59 and disease duration was 1.68 years +/- 0.71. They were on vincristine [VCR] that was given in courses, each course for 2-4 weeks during which a single intravenous dose of VCR was given [1[1/2] mg/m[2]] for 8 courses. We had two groups of patients The first group included 20 children who had ended their courses [8 courses]. The second group comprised 20 children who were still on treatment seven children had four courses, six children had three courses, and seven children had two courses. A control group of 10 healthy volunteers who were matched for age and sex was added. Six patients of both groups had infrequent muscle cramps. All patients of both group were neurologically free. Fifteen children of the first group and only two of the second group had evidence of denervation potentials on electromyographic [EMG] study. Also motor nerve conduction velocity [MNCV] and sensory nerve conduction velocity [SNCV] showed more delay in the first group than in the second group. The mean +/- SD of MNCV was 33.2 m. /sec. +/- 2.8 and 38.1 +/- 4.2 in both groups respectively. SNCV was 29.9 m. /sec +/- 3.1 and 43.2 +/- 5.6 in both groups respectively. Ultrastructural study of nerve biopsies showed more degeneration of the nerve axons with fibrosis as well as degenerative changes in some areas through the myelin sheath in the first group than that of the second group as compared to the normal findings in the control group