Shore T, Barnett M J, Phillips G L
Leukemia and Bone Marrow Transplant Program of British Columbia, Vancouver General Hospital, Canada.
Med Pediatr Oncol. 1990;18(2):159-61. doi: 10.1002/mpo.2950180213.
Methotrexate leukoencephalopathy is a chronic syndrome of ataxia and confusion which may progress to seizures, coma, and death. We report a fatal case of this syndrome in a patient who displayed no evidence of the typical prodrome of neurologic symptoms or signs. This patient suffered brain death after receiving 11 doses of intrathecal methotrexate for leukemic meningitis. Since leukoencephalopathy was not clinically suspected, this case underscores the need for a test that would reliably monitor central nervous system toxicity due to intrathecal therapy.
甲氨蝶呤白质脑病是一种慢性综合征，表现为共济失调和意识模糊，可进展为癫痫发作、昏迷和死亡。我们报告了该综合征的一例致死病例，该患者未表现出典型的神经症状或体征前驱症状。该患者因白血病性脑膜炎接受了11次鞘内注射甲氨蝶呤后发生脑死亡。由于临床上未怀疑白质脑病，该病例强调了需要一种能够可靠监测鞘内治疗所致中枢神经系统毒性的检测方法。
