Cytotoxic Lesion in the Splenium of Corpus Callosum Secondary to Subacute Methotrexate Neurotoxicity
| Autor: | Ahmed Koriesh, Ahmad A Al-Awwad |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
dextromethorphan
Pathology medicine.medical_specialty business.industry Neurotoxicity Splenium Case Report Dextromethorphan Corpus callosum medicine.disease Cerebral edema Lesion Atrophy methotrexate neurotoxicity splenium lesion medicine Medicine Methotrexate medicine.symptom business medicine.drug |
| Zdroj: | Avicenna Journal of Medicine Avicenna Journal of Medicine, Vol 11, Iss 03, Pp 160-162 (2021) |
| ISSN: | 2249-4464 2231-0770 |
| DOI: | 10.1055/s-0041-1732486 |
| Popis: | Methotrexate neurotoxicity can present with a wide spectrum of neurologic symptoms and brain magnetic resonance imaging (MRI) typically demonstrates cerebral edema, demyelination, multifocal white matter necrosis, and atrophy relatively selective for the deep cerebral white matter. Here, we report a case of subacute methotrexate neurotoxicity in a 40-year-old man with B cell acute lymphoblastic leukemia. Brain MRI showed cytotoxic lesion in the splenium of corpus callosum and left middle cerebellar peduncle. Patient significantly improved 24 hours after receiving oral dextromethorphan. Methotrexate neurotoxicity should be suspected in any symptomatic patient receiving high dose of methotrexate or intrathecal methotrexate therapy. Dextromethorphan should be considered in these patients as it can modulate the excitatory responses to homocysteine and its metabolite which are usually elevated in such patients. |
| Databáze: | OpenAIRE |
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