Reversible encephalopathy induced by systemic high dose methotrexate

Abstract

Therapy induced leukoencephalopathy is a known complication for children receiving high dose intravenous methotrexate. It may present as seizure or focal neurological deficit but fortunately the neurological deficits are often transient. We reported 2 local patients who had this complication and no gross persistent neurological complication were noted. From the literature and our experience, MRI is a more sensitive modality in picking up such complication and aminophylline may have a role as a prophylactic agent. A prospective study with appropriate neuropsychological assessment and long term follow-up on patients with this complication is needed to delineate the actual impact of this clinical phenomenon.