Multifocal leukoencephalopathy: occurrence during 5-fluorouracil and levamisole therapy and resolution after discontinuation of chemotherapy.
We report the fourth case of cerebral demyelinating disease associated with 5-fluorouracil and levamisole hydrochloride therapy for adenocarcinoma of the colon. The initial manifestations included subacute progressive decline in mental status, ataxia, dysarthria, and diplopia. Magnetic resonance imaging of the head demonstrated multifocal enhanced lesions in the white matter. The patient experienced improvement, without corticosteroid treatment, from 2 weeks to 4 months after cessation of chemotherapy.
Kimmel
D W
DW
Department of Neurology, Mayo Clinic, Rochester, MN 55905.
Schutt
A J
AJ
D000230:Adenocarcinoma / Q000188:drug therapy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D003110:Colonic Neoplasms / Q000188:drug therapy; D005472:Fluorouracil / Q000009:adverse effects*; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000139:chemically induced*; D007978:Levamisole / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged
D007978:Levamisole; D005472:Fluorouracil