Vol.56 No.4 July 2008
Facial nerve palsy after chemotherapy for maligant lymphoma
Division of Hematology and Oncology, Department of Medicine, Toho University Medical Center, 6-11-1 Ohmorinishi, Ota-ku, Tokyo, Japan
Abstract
Patients with malignant tumors may develop cerebral nerve disorders due to the invasion of tumor cells, infection, and side effects of medication. We report 2 cases in which peripheral facial paralysis developed after completion of chemotherapy for malignant lymphoma. The histological type in both of the 2 cases was diffuse large B cell lymphoma, and the clinical stage was IA. One patient underwent R-CHO (rituximab, cyclophosphamide, and adriamycin) and the other R-CHOP (rituximab, cyclophosphamide, adriamycin, and prednisolone), respectively. Both developed facial paralysis on the right side, one 66 days and the other 31 days after chemotherapy was completed. Although the symptom disappeared after dexamethasone administration of in one patient, drooping mouth on the right side remained in the other despite administration of valacyclovir hydrochloride and prednisolone. The major cause of peripheral facial paralysis was herpes simplex zoster virus (HSV), and concomitant therapy with adrenocortical steroid and antiviral drug is considered effective. When paralysis develops after chemotherapy with an anticancer drug, it is necessary to keep tumor cells from invading the central nervous system, to check for infection caused by HSV, and to start treatment as early as possible because the time from the paralysis development to the start of treatment may adversely affect prognosis.
Key word
malignant lymphoma, chemotherapy, facial nerve paralysis
Received
January 16, 2008
Accepted
April 22, 2008
Jpn. J. Chemother. 56 (4): 472-474, 2008
