Reversible Toxic Encephalopathy related to Treatment with Capecitabine: A Discussion about Chemotherapy-Induced Neurotoxicity and a Case Report

Introduction: Capecitabine is a chemotherapeutic widely used in current medical practice, quickly replacing 5-Fluorouracil in the treatment of certain cancers. Although it is rarely encountered, neurotoxicity is an adverse effect that should not be neglected, especially if elderly patients are involved. Case: An 82-year-old patient, diagnosed with digestive neoplasm, currently being treated with Capecitabine, is brought to the emergency room by her family for an acute confusional episode and speech disorder. Brain imaging is performed, which does not identify significant lesions, and biological tests exclude major imbalances that would explain the neurological dysfunction. Stopping the chemotherapy treatment determines the rapid resolution of the symptoms. Thus, the diagnosis of toxic encephalopathy is made and it is decided to definitively stop treatment with Capecitabine. Conclusion: These being presented, whenever there is an alteration of the neurological status during treatment with Capecitabine, Reversible toxic encephalopathy should be considered. This drug remains a preferred chemotherapy in current practice, but the adverse neurological effects should not be neglected, especially for the population at risk.