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Stroke like syndrome and simple partial seizures secondary to intrathecal methotrexate use for the treatment of acute lymphocytic leukemia. (p6.181)
Conclusions:Our case may be the first reported of seizures and stroke like syndrome in the same patient for ALL treated with MTX. Clinicians should include Methotrexate induced leukoencephalopathy in their differential of seizures, stroke like syndrome and a combination of both. MRI DWI, ADC and FLAIR images should be included in the diagnostic evaluation of MTX induced encephalopathy especially with IT methotrexate.Disclosure: Dr. Fares has nothing to disclose. Dr. Silliman has received research support from Sanofi Genzyme, Biogen Idec, Bristol Myers and Novartis.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Fares, M.-A., Silliman, S. Tags: Neurologic Complications of Cancer Source Type: research

Thiamine Deficiency While on Total Parenteral Nutrition Mimicking Acute Stroke: A Case Report (P3.217)
CONCLUSIONS: Thiamine deficiency mimicking stroke while on total parenteral nutrition has been rarely documented. Recognition of this syndrome is critical as prompt treatment may reverse symptoms.Disclosure: Dr. Parker has nothing to disclose. Dr. Marafie has nothing to disclose. Dr. Wolf has nothing to disclose.
Source: Neurology - April 3, 2016 Category: Neurology Authors: Parker, A., Marafie, D., Wolf, V. Tags: Neurocritical Care: Clinical Science and Therapeutics Source Type: research

Methotrexate Encephalopathy as a Cause of Alternating Hemiplegia (P3.143)
CONCLUSIONS: Transient neurologic dysfunction with reversible MRI abnormality is a recognized consequence of intrathecal methotrexate chemotherapy in childhood ALL. Patients present with dramatic fluctuating neurologic symptoms with associated MRI changes and may be mistaken for stroke or a seizure disorder. Once the syndrome is recognized patients typically recover with supportive management and rehabilitation.Disclosure: Dr. Sullivan has nothing to disclose. Dr. Quealy has nothing to disclose. Dr. Olsevskaite has nothing to disclose. Dr. MacEneaney has nothing to disclose. Dr. Ryan has nothing to disclose. Dr. O'Toole ha...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Sullivan, C., Quealy, J., Olsevskaite, J., MacEneaney, P., Ryan, C., O'Toole, O. Tags: Neuro-oncology: CNS Lymphoma and Other Hematologic Malignancies Source Type: research

Methotrexate Neurotoxicity Mimicking Stroke (P2.296)
Conclusion: It is important for clinicians to recognize methotrexate-induced neurotoxcity as a possible stroke mimic.Disclosure: Dr. Pham has nothing to disclose. Dr. Ermak has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Pham, Q., Ermak, D. Tags: Cerebrovascular Disease and Interventional Neurology: Inflammation and Immunology Source Type: research

A Unique Presentation of Pediatric Stroke Attributed to Intrathecal Methotrexate (P3.309)
CONCLUSIONS:This is a rare case of ischemic watershed infarcts with diffuse reversible cerebral vasospasm, after intrathecal methotrexate. This highlights the need for further research into the pathogenesis of methotrexate neurotoxicity including endothelial damage.Study Supported by:Disclosure: Dr. Ilyas has nothing to disclose. Dr. Williams has nothing to disclose.
Source: Neurology - April 9, 2014 Category: Neurology Authors: Ilyas, M., Williams, M. Tags: Neurologic Complications of Cancer Source Type: research

Teaching NeuroImages: Methotrexate neurotoxicity: Resolution and evolution of MRI changes within 48 hours
A 13-year-old girl presented with acute-onset right hemiparesis involving the face, arm, and leg equally. She was receiving weekly intrathecal methotrexate (last dose 6 days prior) for recently diagnosed acute lymphocytic leukemia. Brain MRI (figure 1) showed diffusion restriction in the left centrum semiovale with reduced apparent diffusion coefficient. Her hemiparesis resolved within 24 hours but 2 hours later, she developed 12-hour left hemiparesis involving face, upper limb, and dysarthria. Follow-up neurologic examination was normal. Repeat MRI (figure 2) 44 hours after the original MRI showed acute right centrum semi...
Source: Neurology - September 2, 2013 Category: Neurology Authors: Kanaan, S., Poddar, K., Ng, Y.-T. Tags: Childhood stroke, MRI, DWI, Chemotherapy-tumor, All Pediatric RESIDENT AND FELLOW SECTION Source Type: research