title: Irreversible paraplegia following one time prophylactic intrathecal chemotherapy in an adult patient with acute lymphoblastic leukemia.
abstract: We present an adult female patient who developed irreversible paraplegia and areflexia four days post intrathecal chemotherapy with methotrexate, cytosine arabinoside and hydrocortisone. On magnetic resonance imaging (MRI) of the lumbar spine, diffuse gadolinium enhancement of the anterior spinal nerve roots (ventral roots) was detected. Methylprednisolone was intravenously administered at a daily dose of 30mg/kg for three days. Despite this treatment, flaccid weakness in the lower extremities and urinary retention persisted. Following consolidation chemotherapy, no improvement in neurologic status was noted. Six months later, a follow-up MRI revealed severe atrophy of the thoracic spinal cord.
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, College of Medicine, Gyeong-Sang National University, Jinju 660-702, Korea.
authors.forename: Hea Yong
authors.initials: HY
authors.lastname: Lee
authors.forename: Sung-il
authors.initials: SI
authors.lastname: Im
authors.forename: Myoung-Hee
authors.initials: MH
authors.lastname: Kang
authors.forename: Kwang Min
authors.initials: KM
authors.lastname: Kim
authors.forename: Seok Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Hun-Gu
authors.initials: HG
authors.lastname: Kim
authors.forename: Jung Hun
authors.initials: JH
authors.lastname: Kang
authors.forename: Gyeong-Won
authors.initials: GW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D010264:Paraplegia / Q000139:chemically induced* / Q000473:pathology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents