Steroid-resistant bilateral facial nerve palsies, ophthalmoparesis, and multilevel thoracic radiculopathy as immune effector cell-associated late-onset neurotoxicity after cilta-cel CAR-T therapy: a case report and review of similar cases - Takeaways - MDSpire

Steroid-resistant bilateral facial nerve palsies, ophthalmoparesis, and multilevel thoracic radiculopathy as immune effector cell-associated late-onset neurotoxicity after cilta-cel CAR-T therapy: a case report and review of similar cases

  • By

  • James Reid Johnson

  • Tanya Gupta

  • Michelle Tavcar

  • Alex Glynn

  • Peter Hedera

  • June 29, 2026

  • 0 min

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  • 1

    CAR-T therapy can lead to neurotoxic side effects, including delayed immune effector cell-associated nerve palsies (IEC-NPs).

  • 2

    A patient with refractory multiple myeloma developed multiple neurologic symptoms after CAR-T therapy, including bilateral facial nerve palsy and thoracic radiculopathy.

  • 3

    The patient's symptoms progressed despite treatment with oral and intravenous steroids, indicating steroid resistance.

  • 4

    Intrathecal methotrexate and systemic cyclophosphamide resulted in acute symptomatic improvement and resolution of diplopia and facial nerve palsies.

  • 5

    This case contributes to the literature on treatment strategies for IEC-NPs, particularly in cases resistant to standard steroid therapy.

Original Source(s)

Steroid-resistant bilateral facial nerve palsies, ophthalmoparesis, and multilevel thoracic radiculopathy as immune effector cell-associated late-onset neurotoxicity after cilta-cel CAR-T therapy: a case report and review of similar cases

  • by James Reid Johnson, Tanya Gupta, Michelle Tavcar, Alex Glynn, Peter Hedera

  • June 29, 2026

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