Neurotoxicity following treatment with methotrexate: A report of two cases

Abstract

Several side effects are associated with methotrexate use, including nausea and vomiting, diarrhea, mucositis, myelosuppression, renal failure, hepatotoxicity, pulmonary toxlcity and alopecia. Methotrexate has little or no neurotoxicity when used orally or intravenously in usual doses. An acute stroke-like encephalopathy with seizures, confusion, hemiparesis and coma may complicate high-dose methotrexate in as many as 15% of patients. In this report we present two cases of neurotoxicity after methotrexate therapy. In the first case acute neurologic abnormalities took place 9 days after Intrathecal therapy and intravenous high dose methotrexate infusion. In the second case we observed the delayed neurotoxicity 22 months after cranial radiotherapy and high dose methotrexate infusion. [Turk J Cancer 1997;27(i):78-83]