RESUMO
El metotrexato es usado en el tratamiento de la leucemia linfoide aguda; puede causar neurotoxicidad, incluyendo una presentación muy infrecuente con hemiparesia. Se describen los casos de 2 adolescentes quienes durante la aplicación de la fase M del protocolo presentaron hemiparesia, paresia facial y disartria que revirtieron de forma rápida, descartándose compromiso leucémico del sistema nervioso central e ictus. Se revisa brevemente la fisiopatología de la neurotoxicidad del metotrexato, las características de la presentación con paresia focal y los hallazgos en la resonancia magnética nuclear (AU)
Methotrexate used in the treatment of acute lymphocytic leukemia, can cause neurotoxicity, including a rare presentation with hemiparesis. We describe two teenagers, who during the implementation of the M phase of the protocol, suffered hemiparesis, facial paresis and dysarthria which quickly reversed. Leukemia involvement of the central nervous system and stroke, were ruled out. We briefly review the pathophysiology of methotrexate neurotoxicity, the characteristics of the focal paresis presentation and magnetic resonance image findings (AU)
Assuntos
Humanos , Feminino , Criança , Paresia/induzido quimicamente , Paralisia Facial/induzido quimicamente , Metotrexato/efeitos adversos , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Neurotoxinas/efeitos adversos , Fatores de Risco , Sepse/complicaçõesRESUMO
Methotrexate used in the treatment of acute lymphocytic leukemia, can cause neurotoxicity, including a rare presentation with hemiparesis. We describe two teenagers, who during the implementation of the M phase of the protocol, suffered hemiparesis, facial paresis and dysarthria which quickly reversed. Leukemia involvement of the central nervous system and stroke, were ruled out. We briefly review the pathophysiology of methotrexate neurotoxicity, the characteristics of the focal paresis presentation and magnetic resonance image findings.
