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July2005 Vol.42 Issue:        2        Table of Contents
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Electroencephalographic Changes with Methotrexate in Childhood Acute Lymphoblastic Leukemia and Lymphoma

Mona H. El-Samahy1, M.A. Abo-El-Asrar1, Nahad Salah2
Departments of Pediatrics1, Neuropsychiatry2, Ain Shams University


The neurological side effects of high dose methotrexate (HD-MTX) and intrathecal MTX in acute lymphoblastic leukemia (ALL) and non-Hodgkin's lymphoma (NHL) patients through the use of EEG recording was investigated in this study. Eighteen patients with ALL and 7 patients with NHL were studied for their EEG changes after each I.V. HD-MTX (2 gm / m²). Focal and generalized EEG changes in both groups of patients after each MTX administration either as systemic high-dose or as intrathecal dose were observed. However, in many of the patients, these findings were transient and disappeared by the time of next HD-MTX. These findings indicate that although HD-MTX and/or intrathecal MTX may occasionally be associated with EEG changes, most of the time these changes are transient and no cumulative EEG changes have to be expected. It is thus suggested that the risk of an acute or sub acute encephalopathy with cortical dysfunction is low. However, subtle sub cortical damage in the deep white matter cannot be ruled out by the EEG alone, and no conclusions on the long-term toxicity can be drawn. If acute neuropsychiatry symptoms or EEG slowing occurs, delayed methotrexate clearance has to be suspected.

(Egypt J. Neurol. Psychiat. Neurosurg., 2005, 42(2): 537-543).


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