Ventral polyradiculopathy with pediatric acute lymphocytic leukemia

Anderson, Stephen C.; Baquis, G; Jackson, Anthony H.; Monteleone, Philip; Kirkwood, J. Robert

doi:10.1002/mus.1219

Cited by 23 publications

(19 citation statements)

References 32 publications

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“…Potential rare complications of ITM therapy are leukoencephalopathy [12,13], encephalomyelopathy [14,15], lumbosacral polyradiculopathy [3,4], neurogenic pulmonary oedema and sudden death [16]. A subacute anterior lumbosacral polyradiculopathy was the cause of progressive flaccid paraparesis without sensory level in our patient.…”

Section: Discussionmentioning

confidence: 91%

“…A subacute anterior lumbosacral polyradiculopathy was the cause of progressive flaccid paraparesis without sensory level in our patient. Clinic cases of ITC-related polyradiculopathy have been previously described as motor syndromes in children, with good recovery after several days to weeks [3,4]. CSF examination reveals mild to moderate elevation of protein, with or without immunoglobulin synthesis.…”

Section: Discussionmentioning

confidence: 94%

“…Following the administration of intrathecal methotrexate (ITM), chemical arachnoiditis and transient inflammatory myelopathy are the most common adverse events [2]. Anterior lumbosacral polyradiculopathy is a rare complication usually reported in children, an inflammatory demyelinating process with habitually good response to immune treatments and complete or almost complete recovery in many cases [3,4]. We report the case of a 30-year-old man diagnosed with acute lymphoblastic leukaemia who developed a subacute anterior lumbosacral polyradiculopathy after ITM administration.…”

Section: Introductionmentioning

confidence: 97%

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Anterior lumbosacral polyradiculopathy after intrathecal administration of methotrexate

Pascual

Coret

Casanova

et al. 2008

Journal of the Neurological Sciences

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 97%

See 1 more Smart Citation

Anterior lumbosacral polyradiculopathy after intrathecal administration of methotrexate

Pascual

Coret

Casanova

et al. 2008

Journal of the Neurological Sciences

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“…[3][4][5][6][7][8] Since 1987 to 2014 a total of 9 children with ALL aged 3-7 years developed neurologic symptoms. The majority (7/9) were boys.…”

Section: Discussionmentioning

confidence: 99%

Acute Polyneuropathy in Children with Acute Lymphocytic Leukemia: Case Report and Systemic Review of the Literature

Gupta¹,

Gupta²

2014

Neuro Open J

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Acute polyneuropathy in children with acute lymphoblastic leukemia is extremely rare, but its onset and association with Guillain-Barré syndrome presents a diagnostic challenge. We report a 5-year-old boy who presented with inability to walk during induction chemotherapy for acute lymphoblastic leukemia. Subsequently he developed painful penile erections, difficulty urinating and swallowing. Besides adding a rare case to the literature and based on a systemic review of the literature, we provide and discuss the neurologic profile and differential diagnosis of the acute polyneuropathy in childhood leukemia. Early recognition of acute polyneuropathy in children with acute lymphocytic leukemia will facilitate a judicious use of immunotherapy for Guillain-Barré syndrome and prevent a high morbidly and mortality.

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“…Another possible explanation is that some agents injure the ventral nerve roots more strongly than the dorsal roots. Anderson et al [8] reported the case of a 3-year-old girl diagnosed with acute lymphoblastic leukaemia who developed subacute anterior lumbosacral polyradiculopathy following intrathecal methotrexate. Her spinal MRI revealed Case report: Gadolinium enhancement of cauda equina…”

Section: Discussionmentioning

confidence: 99%

Gadolinium enhancement of cauda equina after combined spinal–epidural anaesthesia

Takasu

Okita²,

Araki³

et al. 2010

BJR

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ABSTRACT. The occurrence of neurological symptoms after spinal anaesthesia has been reported with several local anaesthetics including lidocaine, prilocaine, mepivacaine, tetracaine and bupivacaine. Although hyperbaric bupivacaine is known to induce neurological symptoms less frequently than lidocaine, a few cases of cauda equina syndrome (CES) following the intraspinal injection of bupivacaine have been reported in the English literature. We describe lumbar MRI findings for a 29-year-old woman presenting with CES after caesarean section. Cauda equina syndrome (CES), a rare complication of spinal or epidural anaesthesia, results from injury to sacral roots in the neural canal. Because the nerves in the cauda equina lack a protective sheath as they pass through the distal end of the dural sac, they are particularly prone to injury from high concentrations of local anaesthetics. Although laboratory findings have suggested that lidocaine, mepivacaine and ropivacaine may have greater potential for neurotoxicity than bupivacaine [1], several cases of CES have been reported in association with the intrathecal injection of bupivacaine [2]. To the best of our knowledge, no spinal MRI findings have been presented for nerve root injury caused by spinal anaesthesia. Case reportA 29-year-old multiparous woman was admitted to the hospital in the 38th week of pregnancy for her second caesarean delivery. Her past medical history was unremarkable. On the second day of hospitalization, she went to the operating room. Combined spinalepidural anaesthesia (CSEA) was performed in the left decubitus position with 2.2 ml 0.5% hyperbaric bupivacaine administered intrathecally at the L3-4 interspace, followed by placement of a multiorifice epidural catheter at the T8-9 interspace. An 18-gauge epidural catheter was positioned 5 cm into the epidural space oriented in the cephalad direction to optimise cephalic spread of the anaesthetic. Surgery was allowed to proceed after sensory block from T5 to S5 was achieved. A total dose of 5.1 ml of 0.2% ropivacaine was administered using a patient-controlled epidural analgesia device over 75 min. Oxygen 3 l min -1 was given through a face mask; 20 min elapsed between induction of anaesthesia and uterine incision. The surgical procedure was completed without incident and the estimated blood loss was 800 ml.The patient did not fully recover from the motor and sensory blockade induced by CSEA, and at about 48 h post-partum was unable to walk because of lower extremity weakness. Neurological assessment confirmed sensory deficit to pinprick and vibration in the T3 to L5 distribution bilaterally with preservation of position sense. On the following day, she still exhibited hypaesthesia bilaterally in the T6 to L2 distribution with lower extremity weakness, which had shown minor improvement. Results of lumbosacral MRI without contrast medium were within normal limits, ruling out the possibility of spinal epidural haematoma or spinal infarction. Because the levels of sensory and motor dysfunction were nea...

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Ventral polyradiculopathy with pediatric acute lymphocytic leukemia

Cited by 23 publications

References 32 publications

Anterior lumbosacral polyradiculopathy after intrathecal administration of methotrexate

Anterior lumbosacral polyradiculopathy after intrathecal administration of methotrexate

Acute Polyneuropathy in Children with Acute Lymphocytic Leukemia: Case Report and Systemic Review of the Literature

Gadolinium enhancement of cauda equina after combined spinal–epidural anaesthesia

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