title: Transient cerebral dysfunction secondary to high-dose methotrexate.
abstract: A transient acute neurologic syndrome occurred in 22 patients receiving high-dose methotrexate (HDMTX) (8 to 9 g/m2) for a variety of malignancies. The neurologic signs were similar in all cases. The syndrome occurred an average of six days after the second or third weekly treatment. Common findings included behavioral abnormalities, focal sensorimotor signs, and abnormal reflexes. Signs often alternated from one side to the other. Evaluations including computed tomography (CT) scan, lumbar puncture, hemogram, and blood chemistry were normal. The EEG revealed some slowing in all cases. The cause of this syndrome is unknown. It is transient and usually does not recur. Its appearance does not preclude further treatment with HDMTX.
authors.forename: R W
authors.initials: RW
authors.lastname: Walker
authors.forename: J C
authors.initials: JC
authors.lastname: Allen
authors.forename: G
authors.initials: G
authors.lastname: Rosen
authors.forename: B
authors.initials: B
authors.lastname: Caparros
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001519:Behavior / Q000187:drug effects; D001927:Brain Diseases / Q000139:chemically induced* / Q000503:physiopathology; D004569:Electroencephalography; D005260:Female; D005910:Glioma / Q000188:drug therapy; D006689:Hodgkin Disease / Q000188:drug therapy; D006801:Humans; D008297:Male; D008527:Medulloblastoma / Q000188:drug therapy; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects* / Q000134:cerebrospinal fluid; D012516:Osteosarcoma / Q000188:drug therapy; D010291:Paresis / Q000139:chemically induced; D012640:Seizures / Q000139:chemically induced; D013577:Syndrome
chemical_list: D008727:Methotrexate