Anterior lumbosacral radiculopathy after intrathecal methotrexate treatment.

Abstract

Intrathecal chemotherapy with methotrexate or cytosine arabinoside is the standard approach to prophylaxis and treatment of central nervous system leukemia in children. Progressive paraplegia, one of the devastating neurologic complications related to this mode of treatment, has been attributed to spinal cord toxicity. Reported are three children who developed progressive paraparesis after intrathecal methotrexate administration followed by complete or partial recovery. Gadolinium enhancement of anterior lumbosacral spinal nerve roots was demonstrated in all three patients, and an elevation of cerebrospinal fluid immunoglobulin G synthesis was evident in two patients with more severe symptoms. The clinical data suggest that anterior lumbosacral radiculopathy is also a type of neurologic complication associated with intrathecal methotrexate treatment.

• Authors: S Koh, M D Nelson Jr, A Kovanlikaya, L S Chen
• Journal: Pediatric neurology (Pediatr Neurol) Vol. 21 Issue 2 Pg. 576-8 (Aug 1999) ISSN: 0887-8994 [Print] United States
• PMID: 10465148 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antimetabolites, Antineoplastic
• Methotrexate

Topics

• Antimetabolites, Antineoplastic (adverse effects)
• Cerebrospinal Fluid (cytology, immunology)
• Child, Preschool
• Humans
• Injections, Spinal
• Magnetic Resonance Imaging
• Male
• Methotrexate (adverse effects)
• Paresis (etiology)
• Peripheral Nervous System Diseases (etiology)
• Precursor Cell Lymphoblastic Leukemia-Lymphoma (drug therapy)
• Spinal Nerve Roots (pathology)