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 |
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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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