Me. Weinblatt et al., TRANSIENT CEREBRAL-DYSFUNCTION DURING TREATMENT OF CHILDHOOD ACUTE LYMPHOBLASTIC-LEUKEMIA, International journal of pediatric hematology/oncology, 2(3), 1995, pp. 227-230
Three adolescents with acute lymphoblastic leukemia developed a transi
ent syndrome of neurologic dysfunction characterized by emotional labi
lity, and, in two patients, fluctuating abnormal neurologic findings.
The symptoms appeared after several doses of a standard weekly intrath
ecal methotrexate regimen. No evidence of structural, infectious, or m
etabolic disorders was found, with diffuse slowing on EEG the only uni
form abnormality. All symptoms resolved spontaneously, with no recurre
nce of the syndrome in any of the patients despite further administrat
ion of intrathecal methotrexate. Conservative management of this syndr
ome is recommended, with no contraindication to further administration
of methotrexate.