Cytotoxic Lesion in the Splenium of Corpus Callosum Secondary to Subacute Methotrexate Neurotoxicity

Methotrexate neurotoxicity can present with a wide spectrum of neurologic symptoms and brain magnetic resonance imaging (MRI) typically demonstrates cerebral edema, demyelination, multifocal white matter necrosis, and atrophy relatively selective for the deep cerebral white matter. Here, we report a...

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Autores principales:	Ahmad A. Al-Awwad, Ahmed Koriesh
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Materias:	methotrexate neurotoxicity splenium lesion dextromethorphan Medicine R
Acceso en línea:	https://doaj.org/article/05a2552e088446b7a214d225a9305f9d
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spelling	oai:doaj.org-article:05a2552e088446b7a214d225a9305f9d2021-12-02T19:15:53ZCytotoxic Lesion in the Splenium of Corpus Callosum Secondary to Subacute Methotrexate Neurotoxicity2231-07702249-446410.1055/s-0041-1732486https://doaj.org/article/05a2552e088446b7a214d225a9305f9d2021-08-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1732486https://doaj.org/toc/2231-0770https://doaj.org/toc/2249-4464Methotrexate neurotoxicity can present with a wide spectrum of neurologic symptoms and brain magnetic resonance imaging (MRI) typically demonstrates cerebral edema, demyelination, multifocal white matter necrosis, and atrophy relatively selective for the deep cerebral white matter. Here, we report a case of subacute methotrexate neurotoxicity in a 40-year-old man with B cell acute lymphoblastic leukemia. Brain MRI showed cytotoxic lesion in the splenium of corpus callosum and left middle cerebellar peduncle. Patient significantly improved 24 hours after receiving oral dextromethorphan. Methotrexate neurotoxicity should be suspected in any symptomatic patient receiving high dose of methotrexate or intrathecal methotrexate therapy. Dextromethorphan should be considered in these patients as it can modulate the excitatory responses to homocysteine and its metabolite which are usually elevated in such patients.Ahmad A. Al-AwwadAhmed KorieshThieme Medical and Scientific Publishers Pvt. Ltd.articlemethotrexate neurotoxicitysplenium lesiondextromethorphanMedicineRENAvicenna Journal of Medicine, Vol 11, Iss 03, Pp 160-162 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	methotrexate neurotoxicity splenium lesion dextromethorphan Medicine R
spellingShingle	methotrexate neurotoxicity splenium lesion dextromethorphan Medicine R Ahmad A. Al-Awwad Ahmed Koriesh Cytotoxic Lesion in the Splenium of Corpus Callosum Secondary to Subacute Methotrexate Neurotoxicity
description	Methotrexate neurotoxicity can present with a wide spectrum of neurologic symptoms and brain magnetic resonance imaging (MRI) typically demonstrates cerebral edema, demyelination, multifocal white matter necrosis, and atrophy relatively selective for the deep cerebral white matter. Here, we report a case of subacute methotrexate neurotoxicity in a 40-year-old man with B cell acute lymphoblastic leukemia. Brain MRI showed cytotoxic lesion in the splenium of corpus callosum and left middle cerebellar peduncle. Patient significantly improved 24 hours after receiving oral dextromethorphan. Methotrexate neurotoxicity should be suspected in any symptomatic patient receiving high dose of methotrexate or intrathecal methotrexate therapy. Dextromethorphan should be considered in these patients as it can modulate the excitatory responses to homocysteine and its metabolite which are usually elevated in such patients.
format	article
author	Ahmad A. Al-Awwad Ahmed Koriesh
author_facet	Ahmad A. Al-Awwad Ahmed Koriesh
author_sort	Ahmad A. Al-Awwad
title	Cytotoxic Lesion in the Splenium of Corpus Callosum Secondary to Subacute Methotrexate Neurotoxicity
title_short	Cytotoxic Lesion in the Splenium of Corpus Callosum Secondary to Subacute Methotrexate Neurotoxicity
title_full	Cytotoxic Lesion in the Splenium of Corpus Callosum Secondary to Subacute Methotrexate Neurotoxicity
title_fullStr	Cytotoxic Lesion in the Splenium of Corpus Callosum Secondary to Subacute Methotrexate Neurotoxicity
title_full_unstemmed	Cytotoxic Lesion in the Splenium of Corpus Callosum Secondary to Subacute Methotrexate Neurotoxicity
title_sort	cytotoxic lesion in the splenium of corpus callosum secondary to subacute methotrexate neurotoxicity
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2021
url	https://doaj.org/article/05a2552e088446b7a214d225a9305f9d
work_keys_str_mv	AT ahmadaalawwad cytotoxiclesioninthespleniumofcorpuscallosumsecondarytosubacutemethotrexateneurotoxicity AT ahmedkoriesh cytotoxiclesioninthespleniumofcorpuscallosumsecondarytosubacutemethotrexateneurotoxicity
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Cytotoxic Lesion in the Splenium of Corpus Callosum Secondary to Subacute Methotrexate Neurotoxicity

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