Intrathecal therapy with methotrexate and cytosine-arabinoside is a therapeutic strategy for maintaining remission in patients with acute lymphoblastic leukemia, that is associated with neurological side effects are described. We report a 4-year-old girl who became tetraplegic after the last dose of intrathecal therapy. Cerebrospinal fluid showed elevated protein level and nerve conduction study revealed a motor neuronopathy. Spine magnetic resonance imaging revealed gadolinium enhancement of the anterior roots of the cauda equina. We describe a myelopathy confined to the anterior horns and anterior spinal nerve roots without sensory involvement caused by intrathecal methotrexate. The pathogenesis of this selective involvement remains uncertain. © 2007 IOS Press. All rights reserved.
Acute motor neuropathy after intrathecal treatment with methotrexate: A case report / Pisani, F.; Scarano, A.. - In: JOURNAL OF PEDIATRIC NEUROLOGY. - ISSN 1304-2580. - 5:3(2007), pp. 247-249. [10.1055/s-0035-1557383]
Acute motor neuropathy after intrathecal treatment with methotrexate: A case report
Pisani F.;
2007
Abstract
Intrathecal therapy with methotrexate and cytosine-arabinoside is a therapeutic strategy for maintaining remission in patients with acute lymphoblastic leukemia, that is associated with neurological side effects are described. We report a 4-year-old girl who became tetraplegic after the last dose of intrathecal therapy. Cerebrospinal fluid showed elevated protein level and nerve conduction study revealed a motor neuronopathy. Spine magnetic resonance imaging revealed gadolinium enhancement of the anterior roots of the cauda equina. We describe a myelopathy confined to the anterior horns and anterior spinal nerve roots without sensory involvement caused by intrathecal methotrexate. The pathogenesis of this selective involvement remains uncertain. © 2007 IOS Press. All rights reserved.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
