eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2024-05-05 12 5 78 80 10.12691/ajmcr-12-5-3 AJMCR20241253 article Nithisha Thatikonda nithatik@utmb.edu 1 Merry Chen 2 Department of Neurology, University of Texas Medical Branch Galveston, Texas Department of Neuro Oncology, MD Anderson Cancer Centre, Texas Chemotherapy-induced peripheral neuropathy (CIPN) involving the autonomic nervous system (ANS) is frequently reported in the literature next to somatic sensory neuropathies. A few chemotherapy agents, such as platinum-based compounds and taxanes, are known to cause dose-dependent cumulative neurotoxicity, wherein autonomic symptoms develop gradually throughout treatment. However, when these chemotherapeutic agents are administered together as a part of a chemotherapy regimen, possible synergistic neurotoxicity is anticipated, even with a single course of treatment. We described a patient who developed severe autonomic dysfunction resulting in neurogenic orthostatic hypotension (nOH) and paralytic ileus after receiving only a single course of paclitaxel-ifosfamide-cisplatin (TIP) regimen for recurrent testicular cancer. The patient was bedridden for six weeks with slow recovery and remained with nOH for three months after discharge. Monitoring ANS parameters (blood pressure, heart rate, and their alterations upon standing) and timely identification of autonomic dysfunction is crucial to introducing treatment modifications/cessations accordingly. https://pubs.sciepub.com/ajmcr/12/5/3/ajmcr-12-5-3.pdf nocturnal orthostatic hypotension autonomic dysfunction cisplatin paclitaxel