{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:10:01Z","timestamp":1756361401766,"version":"3.44.0"},"reference-count":14,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,8,27]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>Capecitabine is an oral fluoropyrimidine used to treat solid tumours such as colorectal and breast cancer. A rare but severe side effect is capecitabine-induced leukoencephalopathy, including bilateral lesion to the corticospinal tract. However, neurological symptoms due to capecitabine treatment are usually reported to be reversible after discontinuation of capecitabine. Here, we present the case of a patient with bilateral degeneration of the corticospinal tract and progressive spastic tetraplegia after chemotherapy with capecitabine mimicking primary lateral sclerosis. Although therapy with capecitabine was ended, symptoms substantially worsened over the following years and the patient finally died from aspiration pneumonia almost 3 years after the application of capecitabine.<\/jats:p>","DOI":"10.1136\/bcr-2019-231248","type":"journal-article","created":{"date-parts":[[2019,9,19]],"date-time":"2019-09-19T07:24:16Z","timestamp":1568877856000},"page":"e231248","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Permanent lesion to the corticospinal tract after therapy with capecitabine"],"prefix":"10.1136","volume":"12","author":[{"given":"Tobias A","family":"Wagner-Altendorf","sequence":"first","affiliation":[{"name":"Department of Neurology, University Hospital Schleswig-Holstein, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcus","family":"Heldmann","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Schleswig-Holstein, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrike","family":"Hanssen","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Schleswig-Holstein, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas F","family":"M\u00fcnte","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital Schleswig-Holstein, L\u00fcbeck, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,9,18]]},"reference":[{"key":"2025082722513496000_12.9.e231248.1","doi-asserted-by":"publisher","DOI":"10.1159\/000078335"},{"key":"2025082722513496000_12.9.e231248.2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000187313.83515.7e"},{"key":"2025082722513496000_12.9.e231248.3","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1177\/1078155209102511","article-title":"Encephalopathy secondary to capecitabine chemotherapy: a case report and discussion","volume":"15","author":"Tipples","year":"2009","journal-title":"Journal of Oncology Pharmacy Practice"},{"key":"2025082722513496000_12.9.e231248.4","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1536\/ihj.54.417","article-title":"Capecitabine Induces Both Cardiomyopathy and Multifocal Cerebral Leukoencephalopathy","volume":"54","author":"Endo","year":"2013","journal-title":"Int Heart J"},{"key":"2025082722513496000_12.9.e231248.5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.neuro.2017.05.001","article-title":"Capecitabine-induced acute toxic leukoencephalopathy","volume":"62","author":"Obadia","year":"2017","journal-title":"Neurotoxicology"},{"key":"2025082722513496000_12.9.e231248.6","doi-asserted-by":"crossref","first-page":"621","DOI":"10.2169\/internalmedicine.0961-18","article-title":"Capecitabine-induced Leukoencephalopathy","volume":"58","author":"Yoshimura","year":"2019","journal-title":"Internal Medicine"},{"key":"2025082722513496000_12.9.e231248.7","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2018-002121"},{"key":"2025082722513496000_12.9.e231248.8","first-page":"10(3), 1","article-title":"Capecitabine-induced leukoencephalopathy involving the bilateral corticospinal tracts","volume":"10","author":"Tan","year":"2016","journal-title":"J Radiol Case Rep"},{"key":"2025082722513496000_12.9.e231248.9","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awr016"},{"key":"2025082722513496000_12.9.e231248.10","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1002\/hbm.23412","article-title":"The corticospinal tract profile in amyotrophic lateral sclerosis","volume":"38","author":"Sarica","year":"2017","journal-title":"Hum Brain Mapp"},{"key":"2025082722513496000_12.9.e231248.11","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/j.nicl.2017.02.017","article-title":"Differential involvement of corticospinal tract (CST) fibers in UMN-predominant ALS patients with or without CST hyperintensity: A diffusion tensor tractography study","volume":"14","author":"Rajagopalan","year":"2017","journal-title":"Neuroimage"},{"key":"2025082722513496000_12.9.e231248.12","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1111\/ane.12713","article-title":"The concept and diagnostic criteria of primary lateral sclerosis","volume":"136","author":"Wais","year":"2017","journal-title":"Acta Neurol Scand"},{"key":"2025082722513496000_12.9.e231248.13","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s002800050891","article-title":"Intrathecal 5-fluoro-2\u2032-deoxyuridine (FdUrd) for the treatment of solid tumor neoplastic meningitis: an in vivo study","volume":"43","author":"Nakagawa","year":"1999","journal-title":"Cancer Chemother Pharmacol"},{"key":"2025082722513496000_12.9.e231248.14","doi-asserted-by":"publisher","DOI":"10.1186\/jbiol69"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-231248","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:51:46Z","timestamp":1756360306000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-231248"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9]]},"references-count":14,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9,18]]},"published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1136\/bcr-2019-231248"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-231248","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,9]]}}}