Methrotexate induced Neurotoxicity mimicking stroke, followi
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Acute lymphocytic leukemia (ALL) is the most prevalent cancer in children. The definitive diagnosis is made specially through myelogram and bone marrow biopsy. Methotrexate (MTX) is an essential drug in the treatment of childhood acute lymphoblastic leukemia (ALL) and may be used alone or in combination with other drugs in a multi-chemotherapy approach. However, MTX has some several side effects attributed to it, such as neurotoxicity, especially administrated intrathecal. Neurotoxicity can be acute, subacute or long-term encephalopathy. The case presented is a classical evolution of a transient encephalopathy with a stroke-like manifestation. It is a rare early adverse effect of MTX medication and resolves in a short period of time with medication for vasodilation (aminophylline). However, focal white matter lesions are firstly shown in diffusion weighted imaging (DWI) and within days can be seen in other sequences. Abnormal diffusion areas vanish as the improvement of clinical symptoms.

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