Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0013362 (dysarthria)
 3,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Temporary neurologic abnormalities were observed in one out of 23 patients undergoing chemotherapy with high-dose methotrexate (HD-MTX) for osteogenic sarcoma. This patient developed sequential symptoms including alternative hemiparesis, dysarthria and altered consciousness 5 days after the second course of HD-MTX (8 gm/m2 by 6 h continuous infusion) with leucovorin rescue. Laboratory evaluations disclosed normal electrolytes, hemograms and non-toxic serum MTX levels at the onset of the symptoms. Computed tomography of the brain was normal but electroencephalography showed focal theta and delta slow waves over the right temporal-parietal-occipital area. The neurological symptoms resolved completely within 72 h.
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PMID:Transient neurological disturbances induced by the chemotherapy of high-dose methotrexate for osteogenic sarcoma. 794 55

Leucoencephalopathy caused by antineoplastic drugs was reviewed. This leucoencephalopathy primarily involved the cerebral white matter, caused by various anti-neoplastic drugs such as carmofur, fluorouracil, cytarabine, cisplatin, tegafur, methotrexate, tacrolimus, and interferon alfa. The interval between the time of drug administration and the onset of leucoencephalopathy varies among the drugs, depending on the kind of the drugs, their daily dosage, duration of the administration, and presence or absence of other combined treatments. This review primarily focused on carmofur-induced leucoencephaloathy, since this drug is developed and widely used in Japan against the carcinomas of the gastrointestinal tract and breast, and has caused leucoencephalopathy at the estimated incidence of 0.026% since 1982. The common symptoms of carmofur leucoencephalopaty were gait disturbance followed by dysarthria and dementia in that order of frequency, leading to coma in the advanced stage of the encephalopathy. EEG is the most sensitive test, but cranial CT and MRI tests are more specific, and MRI T2-weighted imaging is the most useful test, revealing symmetrical bilateral diffuse high intensity areas in the cerebral white matter. Intravenous high dose MTX has a strong tendency to cause leucoencephalopathy when combined with cranial radiation therapy. Reversible posterior leucoencephalopathy proposed by Hinchey et al. in 1996 has also been caused by some antineoplastic drugs. The most important treatment of the leucoencephalopathy caused by antineoplastic drugs is the immediate cessation of the causative drugs, followed by supportive therapy which included treatment to various complications and prevention of the decubitus and contractures of the joints.
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PMID:[Leukoencephalopathy caused by antineoplastic drugs]. 1830 61

A 52-year-old female presented with stroke-like symptoms after high-dose methotrexate (HDMTX) therapy and MTX intrathecal injection (IT-MTX) as central nervous system (CNS) prophylaxis for intravascular large B-cell lymphoma (IVLBCL). She had been diagnosed as having IVLBCL without CNS involvement 5 months earlier and had received 6 courses of R-CHOP and 2 courses of HDMTX combined with IT-MTX. She experienced acute-onset right hemiparesis involving the face and arm, along with dysarthria, 7 days after the second HDMTX infusion. Brain magnetic resonance imaging (MRI) and cerebrospinal fluid results were normal and suggested neither stroke nor CNS infiltration. Her symptoms gradually resolved within 4 days and follow-up neurologic examination showed no abnormalities. MRI on day 2 (after the onset) showed an area of hyper-intensity on diffusion weighted imaging (DWI). Follow-up MRI performed on day 38 showed resolution of the DWI intensity, while the T2 and FLAIR signals became more evident. Based on her clinical course and these MRI findings, she was diagnosed as having MTX-induced subacute encephalopathy. This syndrome has been reported mainly in children with ALL after HDMTX or IT-MTX, but there have been few reports of adult patients. MTX-induced subacute encephalopathy should be taken into account as a possible cause of neurologic manifestations because early differentiation from stroke and CNS infiltration is essential to successful management.
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PMID:[Subacute encephalopathy after high-dose methotrexate as prophylaxis for central nervous system relapse in a patient with intravascular large B-cell lymphoma]. 2587 88