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A Case of Encephalopathy Presented with Motor Aphasia and Quadriplegia Following Intrathecal Methotrexate

Journal of the Korean Pediatric Society 2001;44(9):1066-1069.
Published online September 15, 2001.
A Case of Encephalopathy Presented with Motor Aphasia and Quadriplegia Following Intrathecal Methotrexate
Seon Woo Lee, Eun Hye Park, Hyun-Sang Cho, Jae Kook Cha, Hae Ran Lee
Department of Pediatrics, College of Medicine, Hallym University, Seoul, Korea
운동성 실어증 및 사지마비로 발현된 Methotrexate 관련성 뇌증 1례
이선우, 박은혜, 조현상, 차재국, 이혜란
한림대학교 의과대학 소아과학교실
Correspondence: 
Hyun-Sang Cho, Email: hscho@www.hallym.or.kr
Abstract
Intrathecal administration of methotrexate(IT-MTX) has constituted the standard approach to prophylaxis and treatment of central nevous system(CNS) leukemia. We experienced a quadriplegia and motor aphasia in a 14-year-old boy following repeated IT-MTX for the prophylaxis of meningeal leukemia. He was diagnosed as ALL without CNS involvement and treated by CCG- 1882 protocol. IT-MTX was administered for CNS prophylaxis. The patient began complaining of urinary incontinence, motor aphasia and weakness in his right leg from 12 days after the 5th dose of the IT-MTX therapy. Even though the IT-MTX was discontinued, loss of muscle power progressed upward resulting in quadriplegia. The patient showed slow and partial recovery on right extremities over 3 months. We report this case with brief review of literature.
Key Words: Intrathecal methotrexate, Quadriplegia, Motor aphasia


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