Methotrexate leukoencephalopathy presenting as Klüver-Bucy syndrome and uncinate seizures Journal Article


Authors: Antunes, N. L.; Souweidane, M. M.; Lis, E.; Rosenblum, M. K.; Steinherz, P. G.
Article Title: Methotrexate leukoencephalopathy presenting as Klüver-Bucy syndrome and uncinate seizures
Abstract: Methotrexate causes several biochemical changes that impact the nervous system. The neurotoxicity usually affects the cerebral white matter, causing a leukoencephalopathy that can be chronic and progressive with cognitive decline. A 15-year-old male developed olfactory seizures and behavioral abnormalities (hypersexuality, placidity, and memory disturbances) compatible with partial Klüver-Bucy syndrome after treatment for central nervous system leukemia with intraventricular methotrexate. A magnetic resonance imaging study revealed evidence of white matter disease affecting both temporal lobes. A brain biopsy revealed a necrotizing encephalopathy compatible with methotrexate-related white matter injury. It may be prudent to verify normal cerebrospinal fluid dynamics before the administration of intraventricular methotrexate in children with a history of central nervous system leukemia. © 2002 by Elsevier Science Inc. All rights reserved.
Keywords: adolescent; leukemia; clinical feature; disease course; case report; cytarabine; methotrexate; neurotoxicity; nuclear magnetic resonance imaging; antimetabolites, antineoplastic; diagnosis, differential; dexamethasone; vincristine; thiotepa; brain; cerebrospinal fluid; temporal lobe; enzyme inhibitors; asparaginase; glucocorticoid; leukoencephalopathy, progressive multifocal; seizure; behavior disorder; brain biopsy; amnesia; leukoencephalopathy; white matter; carbamazepine; epilepsies, partial; humans; human; male; priority journal; article; dextromethorphan; brain leukemia; kluver bucy syndrome; kluver-bucy syndrome
Journal Title: Pediatric Neurosurgery
Volume: 26
Issue: 4
ISSN: 1016-2291
Publisher: Karger  
Date Published: 2002-04-01
Start Page: 305
End Page: 308
Language: English
DOI: 10.1016/s0887-8994(01)00376-9
PUBMED: 11992760
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 14 November 2014 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Eric Lis
    104 Lis
  2. Nuno L Antunes
    22 Antunes
  3. Marc Rosenblum
    255 Rosenblum
  4. Peter G Steinherz
    169 Steinherz