Oxaliplatin-Induced Tonic-Clonic Seizures

Oxaliplatin is a common chemotherapy drug used for colon and gastric cancers. Common side effects are peripheral neuropathy, hematological toxicity, and allergic reactions. A rare side effect is seizures which are usually associated with posterior reversible leukoencephalopathy syndrome (PRES). A 50-year-old male patient presented with severe abdominal pain. CT scan of the abdomen showed acute appendicitis. Appendectomy was done and pathology showed mixed adenoneuroendocrine carcinoma. Adjuvant chemotherapy was started with Folinic acid, Fluorouracil, and Oxaliplatin (FOLFOX). During the third cycle of FOLFOX, the patient developed tonic-clonic seizures. Laboratory workup was within normal limits. EEG and MRI of the brain showed no acute abnormality. The patient was rechallenged with FOLFOX but he had tonic-clonic seizures for the second time. His chemotherapy regimen was switched to Folinic acid, Fluorouracil, and Irinotecan (FOLFIRI). After 5 cycles of FOLFIRI, the patient did not develop any seizures, making Oxaliplatin the most likely culprit for his seizures. Oxaliplatin-induced seizures rarely occur in the absence of PRES. One case report has been described in the literature. We present a rare case of tonic-clonic seizures in a patient receiving Oxaliplatin in the absence of PRES

Oxaliplatin-Induced Tonic-Clonic Seizures

Oxaliplatin is a common chemotherapy drug used for colon and gastric cancers. Common side effects are peripheral neuropathy, hematological toxicity, and allergic reactions. A rare side effect is seizures which are usually associated with posterior reversible leukoencephalopathy syndrome (PRES). A 50-year-old male patient presented with severe abdominal pain. CT scan of the abdomen showed acute appendicitis. Appendectomy was done and pathology showed mixed adenoneuroendocrine carcinoma. Adjuvant chemotherapy was started with Folinic acid, Fluorouracil, and Oxaliplatin (FOLFOX). During the third cycle of FOLFOX, the patient developed tonic-clonic seizures. Laboratory workup was within normal limits. EEG and MRI of the brain showed no acute abnormality. The patient was rechallenged with FOLFOX but he had tonic-clonic seizures for the second time. His chemotherapy regimen was switched to Folinic acid, Fluorouracil, and Irinotecan (FOLFIRI). After 5 cycles of FOLFIRI, the patient did not develop any seizures, making Oxaliplatin the most likely culprit for his seizures. Oxaliplatin-induced seizures rarely occur in the absence of PRES. One case report has been described in the literature. We present a rare case of tonic-clonic seizures in a patient receiving Oxaliplatin in the absence of PRES

A Comprehensive Vowel Space for Whispered Speech

Whispered speech is a relatively common form of communications, used primarily to selectively exclude or include potential listeners from hearing a spoken message. Despite the everyday nature of whispering, and its undoubted usefulness in vocal communications, whispers have received relatively little research effort to date, apart from some studies analyzing the main whispered vowels and some quite general estimations of whispered speech characteristics. In particular, a classic vowel space determination has been lacking for whispers. For voiced speech, this type of information has played an important role in the development and testing of recognition and processing theories over the past few decades and can be expected to be equally useful for whisper-mode communications and recognition systems. This article aims to redress the shortfall by presenting a vowel formant space for whispered speech and comparing the results with corresponding phonated samples. In addition, because the study was conducted using speakers from Birmingham, the analysis extends to discuss the effect of the common British West Midlands accent in comparison with Standard English (Received Pronunciation). Thus, the article presents the analysis of formant data showing differences between normal and whispered speech while also considering an accentual effect on whispered speech

The interaction of lexical and phrasal prosody in whispered speech

The production and perception of Dutch whispered boundary tones, i.e., phrasal prosody, was investigated as a function of characteristics of the tone-bearing word, i.e., lexical prosody. More specifically, the disyllabic tone-bearing word also carried a pitch accent, either on the same syllable as the boundary tone (clash condition), or on the directly adjacent syllable (no clash condition). In a statement/question classification task listeners showed moderate, but above-chance performance for both conditions in whisper, which, however, was much worse as well as slower than in normal speech. The syllabic rhymes of speakers' productions were investigated for acoustic correlates of boundary tones. Results showed mainly secondary cues to intonation, that is, cues that are present in whisper as in normal speech, but minimal compensatory cues, which would reflect speakers' efforts to enhance their whispered speech signal in some way. This suggests that multiple prosodic events in close proximity are challenging to perceive and produce in whispered speech. A moderate increase in classification performance was found when that acoustic cue was enhanced that whispering speakers seemed to employ in a compensatory way: changing the spectral tilt of the utterance-final syllable improved perception of especially the poorer speakers and of intonation on stressed syllables. (C) 2014 Acoustical Society of America