Version May 2024
| Drug | Clinical manifestations | Recovery | |||
| Sensory | Motor | Reflexes | Autonomic | ||
| Platinum compounds | |||||
| Cisplatin | Distal, symmetric loss of sensation to all modalities, stocking glove distribution; painful paresthesias or numbness | Normal | In proportion to sensory loss | Rare | Partial; may progress for several months after drug is discontinued |
| Carboplatin | Similar but less severe than with cisplatin | Normal | Usually normal | Rare | Similar to cisplatin |
| Oxaliplatin | |||||
| Acute | Cold-induced dysesthesias in mouth, throat, and upper limbs | Cramps and/or muscle spasm in throat muscles | Usually normal | None | Gets better within one week, but persists between two-week cycles; improves after chemotherapy is completed |
| Chronic | Similar to cisplatin; symptoms worse in upper extremities during active therapy, but upper extremity neuropathy improves faster than lower extremity neuropathy after treatment completion. One year after treatment completion, there is more neuropathy in lower extremities. | Normal | Usually normal | Rare | Generally starts to improve approximately three months after completion of chemotherapy; can be a chronic problem for some patients. |
| Vinca alkaloids | |||||
| Vincristine | Distal sensory loss lower extremities, rarely affects upper extremities; vinblastine and vinorelbine are less neurotoxic; vincristine - rare mononeuropathies | Less common; distal symmetric weakness in lower limbs progressing to foot drop | Early decrease or absent | Constipation common (especially vincristine), orthostatic hypotension less common | Usually resolves within three months; may persist with vincristine |
| Vinblastine | |||||
| Vinorelbine | |||||
| Vindesine | |||||
| Taxanes | |||||
| Paclitaxel | Mild distal loss of sensation to all modalities, feet greater than hands, painful paresthesias | Occasional mild weakness in foot muscles; myalgia, myopathy | Reduced ankle reflexes | Rare | Usually improves after treatment, but persistent symptoms in about 50% of patients one year later |
| Docetaxel | |||||
| Bortezomib | Mild to moderate distal symmetric loss of sensation to all modalities in distal extremities; painful paresthesias | Occasional mild distal weakness in lower limbs; rare severe distal weakness; muscle cramps and fasciculations rare | In proportion to sensory loss | Occasional, including orthostatic hypotension, diarrhea, and constipation | Usually resolves within three months; may persist |
| Ixabepilone | Painful paresthesias; distal loss of sensation | 10 to 16% have weakness | Rare | Rare | Usually improves after stopping |
| Thalidomide | Symmetric mild to moderate distal loss to all sensory modalities | Weakness and tremor in 30 to 40%; muscle cramps and fasciculations common | In proportion to sensory loss | Constipation; other manifestations (impotence, bradycardia) are rare | Partially reversible; may persist for over one year |
| Lenalidomide | |||||
| Pomalidomide | |||||
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