Acute transient cerebral toxicity associated with administration of high-dose methotrexate. A case report

To report the first case of transient central nervous system toxicity after administration of high-dose methotrexate [HDMTX] in the Middle East. Clinical Presentation: A 10-year-old boy was diagnosed with osteosarcoma of the proximal end of the left tibia. He underwent primary amputation and was started on adjuvant chemotherapy, which included administration of HDMTX. He developed acute cerebral toxicity after the 5th dose of HDMTX in the form of diplopia, seizures and disorientation. He recovered completely without any complication or neurological sequelae. The acute cerebral toxicity associated with HDMTX was completely reversible and without any sequelae