Anterior lumbosacral radiculopathy after intrathecal methotrexate treatment

Intrathecal chemotherapy with methotrexate or cytosine arabinoside is the s tandard approach to prophylaxis and treatment of central nervous system leu kemia in children. Progressive paraplegia, one of the devastating neurologi c complications related to this mode of treatment, has been attributed to s pinal cord toxicity. Reported are three children who developed progressive paraparesis after intrathecal methotrexate administration followed by compl ete or partial recovery, Gadolinium enhancement of anterior lmnbosacral spi nal nerve roots was demonstrated in all three patients, and an elevation of cerebrospinal fluid immunoglobulin G synthesis was evident in two patients with more severe symptoms, The clinical data suggest that anterior lumbosa cral radiculopathy is also a type of neurologic complication associated wit h intrathecal methotrexate treatment, (C) 1999 by Elsevier Science Inc, All rights reserved.