Kimmel D W, Wijdicks E F, Rodriguez M
Department of Neurology, Mayo Clinic, Rochester, MN 55905.
Neurology. 1995 Feb;45(2):374-6. doi: 10.1212/wnl.45.2.374.
Cerebral demyelinating disease developed in a patient during adjuvant therapy with levamisole for malignant melanoma. This patient had no evidence of previous neurologic disease. Levamisole was administered for 5 weeks (total dose, 1,500 mg). Over a period of 3 weeks, the patient became progressively confused and ataxic. MRI with gadolinium enhancement demonstrated prominent multifocal enhancing white matter lesions. CSF examination revealed an inflammatory profile. After discontinuation of treatment with levamisole and a short course of corticosteroid therapy, the patient's condition dramatically improved. MRI also indicated improvement. Observations in our patient suggest that the leukoencephalopathy that developed in previously reported patients who received 5-fluorouracil and levamisole may have been caused at least partly by levamisole.
一名恶性黑色素瘤患者在接受左旋咪唑辅助治疗期间发生了脑脱髓鞘疾病。该患者既往无神经疾病证据。给予左旋咪唑治疗5周（总剂量1500毫克）。在3周内，患者逐渐出现意识模糊和共济失调。钆增强MRI显示明显的多灶性强化白质病变。脑脊液检查显示有炎症表现。停用左旋咪唑并进行短期皮质类固醇治疗后，患者病情显著改善。MRI也显示有改善。对我们患者的观察表明，先前报道的接受5-氟尿嘧啶和左旋咪唑治疗的患者中发生的白质脑病可能至少部分是由左旋咪唑引起的。
