Generalized Tonic Seizures Following Oxaliplatin Based Chemotherapy: A Case Report and Review of the Literature

Feki J, Boudawara O, Dammak M and Khanfir A

Published on: 2023-12-24

Abstract

Perioperative chemotherapy with 5-Fluorouracil, Leucovorin, Oxaliplatin and Docetaxel (FLOT) became the standard of care in resectable gastric cancer. Central neurologic toxicity is a rare side effect of this regimen. We report the case of a 73-year-old woman with stage IIA gastric cancer who developed generalized tonic seizures 4 days after the first FLOT injection. Seizures lasted less than 2 minutes with full recovery. Laboratory workup was normal. Brain imaging showed no signs of metastasis or posterior reversible leukoencephalopathy syndrome (PRES). An electroencephalogram done 48 hours after the seizures was unremarkable. Considering the dMMR status, the medical team opted to discontinue chemotherapy and refer the patient for surgery. The most likely incriminated drug is Oxaliplatin. Three cases of Oxaliplatin induced seizures in the absence of PRES have been documented.