Reactions 1704, p244 - 2 Jun 2018 Neurotoxicity and cytotoxic oedema: case report A 16-year-old boy developed neurotoxicity and cytotoxic oedema following treatment with methotrexate [dosage not stated]. The boy, who had acute lymphoblastic leukaemia, received treatment with intrathecal methotrexate. Ten days following the treatment, he developed acute onset of right hemibody and facial numbness, which progressed to right-sided (arm greater than leg) weakness, aphasia and right facial droop. A brain MRI showed focal areas of restricted diffusion in the centrum semiovale bilaterally, slightly more extensively on the left than the right. Initially, he was diagnosed with methotrexate-related stroke-like syndrome. However, diffusion-weighted imaging findings were suggestive of cytotoxic oedema. He was managed conservatively, and all neurological related events resolved within three days. Author comment: "Neurotoxicity from the chemotherapeutic agents can produce various symptoms. High-dose methotrexate related stroke-like syndrome develops acutely within two to three weeks of exposure, associated with characteristic restricted diffusion changes on MRI. However, the findings are reversible and suggestive of a cytotoxic edema, rather than ischemia. Resolution of MRI changes within 48 hours has been observed." Willis E, et al. A Not Uncommon Cause of Stroke Mimicker in Children. Pediatric Neurology 80: 92-93, Mar 2018. Available from: URL: http://doi.org/10.1016/ j.pediatrneurol.2017.11.001 - USA 803323983 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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