MedlinePlus Medical Encyclopedia: Neuropathy secondary to drugs

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Neuropathy secondary to drugs

Contents of this page:
Illustrations Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Expectations (prognosis) Complications Calling your health care provider Prevention

Illustrations

Central nervous system

Definition Return to top

Neuropathy secondary to drugs is a condition where there is a loss of sensation (or movement) in a part of the body. It is associated with use of a medication that can damage nerves.

Causes, incidence, and risk factors Return to top

The damage is caused by toxic effects of certain medications on the peripheral nerves (the nerves not in the brain or spinal cord). There is usually evidence of damage to the axon part of the nerve cell, which blocks conduction of the nerve impulse through the cell.

Most commonly, there is involvement of multiple nerves (polyneuropathy) which usually appears as sensation changes that begin in outward areas of the body (distal) and progress toward the center of the body (proximal). Occasionally, there may also be changes in movement.

Many medications can be associated with the development of neuropathy, including:

Heart or blood pressure medications
- Amiodarone
- Hydralazine
- Perhexiline
Drugs used to fight cancer
- Vincristine
- Cisplatin
Drugs used to fight infections
- Metronidazole (Flagyl)
- Nitrofurantoin
- Thalidomide (used to fight leprosy)
- INH (isoniazid) -- used against tuberculosis
Drugs used to treat skin conditions (Dapsone)
Anticonvulsants (Phenytoin)
Anti-alcohol drugs (Disulfiram)

Symptoms Return to top

Numbness, loss of sensation
Tingling, abnormal sensations
Sensation changes usually begin in the feet or hands and progress inward

Signs and tests Return to top

A neurological examination may show abnormalities. Blood levels of the medication may show toxic levels. Normal blood levels of certain drugs may be toxic in elderly or other highly susceptible persons.

Treatment Return to top

Treatment is based on the symptoms and their severity.

Medications may be used to control painful neuropathy. However, the use of medications is usually discouraged unless absolutely necessary. Over-the-counter analgesics may be helpful for mild pain. Narcotic analgesics, such as codeine, may be needed to control severe pain. Antidepressant medications, or anticonvulsants (such as carbamazepine or phenytoin), may be helpful for some types of nerve pain.

The medication causing the neuropathy may be stopped, reduced in dose, or changed to another medication. (Any changes in medication should only occur as recommended by the health care provider).

Loss of sensation may require additional safety measures or other interventions to compensate for the loss of sensation.

Expectations (prognosis) Return to top

In many cases, a partial or full return to normal function is possible. The disorder is not usually associated with life-threatening complications, but it can be uncomfortable or disabling.

Complications Return to top

Permanent loss of sensation (or rarely, movement) of an area
Inability to function at work or home because of permanent loss of sensation

Calling your health care provider Return to top

Call your health care provider if you are taking any medication and you experience a loss of sensation or movement of any area of the body.

Prevention Return to top

The health care provider will closely supervise treatment with any medication that may cause neuropathy. The goal is to maintain a therapeutic level (the amount of medication needed to control diseases/symptoms) while preventing toxic levels of the medication.

Update Date: 5/8/2003

Updated by: Elaine T. Kiriakopoulos, M.D., M.Sc., Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network.

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