Subject(s)
Dystonia/diagnosis , Foot Deformities, Acquired/diagnosis , Parkinson Disease/diagnosis , Adult , Aged , Dystonia/chemically induced , Dystonia/drug therapy , Foot Deformities, Acquired/chemically induced , Foot Deformities, Acquired/drug therapy , Humans , Levodopa/adverse effects , Levodopa/therapeutic use , Parkinson Disease/drug therapyABSTRACT
Vincristine has been demonstrated to be a neurotoxic agent with distal axonal degeneration progressing proximally. Five children with acute lymphoblastic leukemia developed bilateral peroneal nerve palsies with equinocavus deformities. Three developed fixed contractures requiring surgical correction. One patient was braced prior to development of fixed deformity and the other had physical therapy preventing fixed deformities and did not require surgery. All of the children obtained complete return of peroneal nerve function. Proper bracing and/or physical therapy at the time of diagnosis of neurologic deficit will prevent fixed contractures and the necessity for surgery.
Subject(s)
Foot Deformities, Acquired/chemically induced , Leukemia, Lymphoid/drug therapy , Peroneal Nerve/drug effects , Vincristine/adverse effects , Braces , Child , Child, Preschool , Female , Foot Deformities, Acquired/diagnostic imaging , Foot Deformities, Acquired/therapy , Humans , Male , Peroneal Nerve/physiopathology , Physical Therapy Modalities , RadiographyABSTRACT
Telescoped digits of the hands and feet developed in a 69-year-old male with severe chronic tophaceous gout during allopurinol treatment. Extensive osseous tophi, resorbed rapidly during therapy with this xanthine oxidase inhibitor and not replaced by new bone matrix, were responsible for the deformity. Several hypotheses are advanced to explain the failure of bone erosions to heal.
