TRANSIENT CEREBRAL-DYSFUNCTION DURING TREATMENT OF CHILDHOOD ACUTE LYMPHOBLASTIC-LEUKEMIA

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.