Anterior lumbosacral polyradiculopathy after intrathecal administration of methotrexate

Pascual, Ana; Coret, Francisco; Casanova, Bonaventura; Láinez, Miguel J. A.

doi:10.1016/j.jns.2007.09.035

Cited by 17 publications

(7 citation statements)

References 25 publications

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“…Otherwise, mono or multifocal vasculitic pattern seen in neurolinfomatosis provokes a focal and direct nerve infiltration. 28 In cases such as acute or subacute paraplegia related to lumbar polyradiculoneuropathy, finding the underlying mechanism (neurotoxic or immune-mediated) is challenging as it is observed in 4 [15][16][17][18] out of 11 cases reported in Table 2. First, high protein concentration in the CSF may be present in both scenarios, and it was seen in six cases treated with MTX-it.…”

Section: Discussionmentioning

confidence: 99%

Acute lumbar polyradiculoneuropathy as early sign of methotrexate intrathecal neurotoxicity: Case report and literature review

Montejo

Navarro‐Otano

Mayà

et al. 2019

Clinical Case Reports

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Key Clinical Message Acute paraplegia after treatment with intrathecal methotrexate requires a complete spinal cord neuroimaging as well as electrodiagnostic examination. The absence of lumbosacral F waves motor responses without demyelinating findings may indicate early direct root toxicity. Early electromyography (EMG) screening could be a valuable tool for detecting peripheral neurotoxicity.

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Section: Discussionmentioning

confidence: 99%

Acute lumbar polyradiculoneuropathy as early sign of methotrexate intrathecal neurotoxicity: Case report and literature review

Montejo

Navarro‐Otano

Mayà

et al. 2019

Clinical Case Reports

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“…52,54 Methotrexate toxicity may lead to disruption of the blood-nerve barrier. 52,57 In a series of three pediatric patients, however, two of the children had increased CSF IgG, and an immune response might be involved. 52…”

Section: Toxic Causesmentioning

confidence: 97%

“…The isolated involvement of the anterior nerve roots explains the lack of sensory symptoms . Methotrexate toxicity may lead to disruption of the blood‐nerve barrier . In a series of three pediatric patients, however, two of the children had increased CSF IgG, and an immune response might be involved …”

Section: Toxic Causesmentioning

confidence: 99%

Spinal Nerve Root Enhancement on MRI Scans in Children: A Review

Kontzialis

Poretti

Michell

et al. 2015

Journal of Neuroimaging

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Spinal nerve root enhancement in pediatric patients is generally nonspecific, and clinical and laboratory correlation is essential. Nerve root enhancement indicates lack of integrity of the blood-nerve barrier. In this review, we will present a range of pediatric conditions that can present with spinal nerve root enhancement including inflammatory, infectious, hereditary, and neoplastic causes. Familiarity with the various pathologic entities associated with spinal nerve root enhancement is important for a concise differential diagnosis in the appropriate clinical setting. This will avoid unnecessary additional investigations.

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“…Allgemeine leukenzephalopathische Veränderungen sind, teilweise in bis zu 60 % der Fälle, als Langzeitfolgeschäden von Methotrexat beschrieben und tragen zu kognitiven Defi ziten nach einer MTXChemotherapie bei [ 78 , 86 ] . Auf spinaler Ebene sind insbesondere nach intrathekaler Applikation transverse Myelopathien [ 87 , 88 ] mit (in-) kompletten Querschnittssyndromen und Polyradikulitiden [ 89 ] mit radikulären Syndromen und/ oder neuropathischen Schmerzen nach Methotrexattherapie dokumentiert. Die zugrundeliegenden Mechanismen der MethotrexatNeurotoxizität sind bisher nur unzureichend verstanden.…”

Section: Proteasominhibitorenunclassified

Neurologische Nebenwirkungen von Zytostatika

2014

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▼With an increasing incidence of malignancies, the number of patients treated with cytostatic chemotherapy is rising continuously. Neurological sequelae of tumor therapy are a growing concern as improved therapy protocols increase the life expectancy of patients. Despite the postmitotic state of neurons, neurotoxic phenomena are amongst the most common side eff ects of many cytostatic drugs, second only to hematological or gastroenterological toxicities. Chemotherapy-induced neurotoxic phenomena represent a medical problem as they can be dose limiting, thus preventing optimal therapy, and lead to longlasting limitations in quality of life. There are hardly any validated therapeutic or preventive approaches to neurotoxic side eff ects of cytostatic drugs. In view of the large number of possible neurotoxic symptoms, knowledge of chemotherapy-induced neurological pathologies in the central and peripheral nervous system is of practical relevance for making a diff erential diagnosis. In the context of ever more complex treatment protocols and increasing number of cytostatic drugs, we review the neurological side eff ects of chemotherapeutic drugs in general use in the peripheral and central nervous system and discuss potential therapeutic strategies. In the fi rst part, this review focuses on side eff ects in the peripheral nervous system of platinum-based antineoplastic drugs (cisplatin, carboplatin, oxaliplatin), vincaalcaloids (vincristine), taxanes (paclitaxel, docetaxel), proteasome inhibitors (bortezomib) and biologicals (brentuximab-vedotin). The second part is dedicated to neurotoxic side eff ects in the central nervous system induced by antimetabolites (methotrexate, 5-fl uoruracil, cytarabine, fl udarabine), alkylating agents (ifosfamide), platinum-based antineoplastic drugs (cisplatin), vincaalcaloids (vincristine), receptor tyrosine kinase inhibitors (imatinib, sorafenib, sunitinib) and biologicals (bevacizumab). In the third part

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Anterior lumbosacral polyradiculopathy after intrathecal administration of methotrexate

Cited by 17 publications

References 25 publications

Acute lumbar polyradiculoneuropathy as early sign of methotrexate intrathecal neurotoxicity: Case report and literature review

Acute lumbar polyradiculoneuropathy as early sign of methotrexate intrathecal neurotoxicity: Case report and literature review

Spinal Nerve Root Enhancement on MRI Scans in Children: A Review

Neurologische Nebenwirkungen von Zytostatika

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