What are the possible complications of Charcot-Marie-Tooth (CMT) disease?

Updated: May 22, 2018
  • Author: Timothy C Parsons, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Patients with CMT are more susceptible to compression neuropathies and radiculopathies. Sprains and fractures are disabling and avoidable.

Medication toxicity is important to recognize when it occurs so that the offending agent can be discontinued. Preventing exposure to neurotoxic medications when possible is preferable. Weimer and Podwall found 26 case reports of CMT and toxic medication effects; 22 of these reports pertained to vincristine, 2 implicated nucleoside analogs, 2 cisplatin, 1 carboplatin, and 1 taxoids. The 22 reports about vincristine included 30 patients, and 26 of these patients had undiagnosed CMT. Only 10 had overt clinical signs or a known close relative with CMT, and many of them developed symptoms after only 1 or 2 doses. [102]

Vinca alkaloid (Vincristine) is considered a definite high-risk medication for the development of CMT (including asymptomatic CMT). Prior to use, all patients should be asked about a family history of neuropathy and joint deformity and examined for clinical signs of a chronic neuropathy.

Commonly used medications that pose moderate to significant risk include the following:

  • Amiodarone (Cordarone)

  • Bortezomib (Velcade)

  • Cisplatin and Oxaliplatin

  • Colchicine (extended use)

  • Metronidazole (extended use)

  • Nitrofurantoin

  • Pyridoxine (mega dose of Vitamin B-6)

  • Taxols (paclitaxel, docetaxel)

A complete list of potentially neurotoxic drugs can be found at the Charcot-Marie-Tooth Association.


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