Oxaliplatin-induced hyperexcitability syndrome in a patient with pancreatic cancer.

A recent pooled analysis and a meta-analysis suggested a survival benefit of gemcitabine-platinum doublets when compared with single agent gemcitabine in pancreatic cancer. Sensory neurotoxicity is a potentially limiting toxicity associated with oxaliplatin therapy. In this letter, we describe a case of a patient with metastatic pancreatic cancer who developed acquired neuromyotonia while receiving intravenous oxaliplatin as part of her treatment. It is a condition characterized by cramps, muscle twitching, weakness, myotonia and pseudomyotonia (slow muscle relaxation after forceful contraction). Her symptoms were ameliorated after initiation of pregabalin. We postulate that hyperexcitability syndrome associated with administration of oxaliplatin can be treated with pregabalin. Future studies will be needed to confirm this as well as to determine the long-term adverse effects associated with pregabalin.