MYELOPATHY AFTER INTRATHECAL CHEMOTHERAPY - A CASE-REPORT WITH UNIQUEMAGNETIC-RESONANCE-IMAGING CHANGES

Background. Paraplegia caused by intrathecal chemotherapy has no known pathognomonic features and is a diagnosis of exclusion. Methods. The authors reported the clinical and neuroimaging findings in one patient with this syndrome. Results. The patient had severe paraplegia with u rinary retention and impaired pain and touch sensation below T-10 with sparing of proprioception and vibration sense. Magnetic resonance ima ging (MRI) scan showed diminished intensity throughout the central cer vical spinal cord. Post-gadopentetate dimeglumine enhancement was scat tered throughout the cervical spinal cord and in two areas of the dors al spinal cord. Axial views of the cervical spinal cord showed that th is enhancement was limited to the lateral columns. Conclusions. The MR I in myelopathy due to intrathecal chemotherapy may show a unique patt ern of post-gadopentetate dimeglumine enhancement limited to the later al columns of the spinal cord. However, two recently encountered patie nts with the same syndrome did not show similar changes.