Uncomplicated Peripheral neuropathy – Moderate

Management escalation pathway

  • Withhold ICPI
  • Initial observation reasonable vs direct iniation of prednisolone 0.5 to 1 mg/kg (if progressing, e.g. from mild)
  • Pregabalin or duloxetine might be introduced for pain
  • If no clinical improvement after 48h, manage as severe
  • Consider Myasthenia Gravis, GBS or CIDP
  • Only consider resuming ICPI after multidisciplinary discussion
Advice on steroid wean:
  • Conversion from i.v. to oral steroids at clinician discretion once improvement is noted
  • Suggested oral prednisolone taper for 4-8 weeks
  • Consider PJP prophylaxis, vitamin D if > 4-weeks duration

Assessment and Investigations

  • Consider EMG for lower moter neuron and/or sensory change
  • Neurological consult
  • Perform imagery to exclude local compression due to cancer progression


CMV: Cytomegalovirus
CIDP: Chronic Inflammatory Demyelinating Polyneuropathy
GBS: Guillain Barré Syndrome
PJP: Pneumocystis Jirovei Pneumopathy