Stroke-Like Hemiparesis During Acute Lymphoblastic Leukemia Treatment

In this case report; a 12-year-old male with acute lymphoblastic leukemia who developed transient left hemiparesis associated with dysphasia and central facial paralysis 14 days after high dose methotrexate (5g/m2 ) and intrathecal methotrexate (12 mg, according to age) treatment has been reported. Cranial magnetic resonance imaging revealed restricted diffusion in bilateral centrum semiovale compatible with methotrexate-induced acute encephalopathy. All clinical symptoms resolved completely without any treatment. Clinical findings including headache, nausea, emesis, lethargy, altered mental status, blurred vision, aphasia, dysphasia, hemiparesis and cranial magnetic resonance imaging findings of restricted diffusion that does not comply with the territory of any artery should alert the physician for methotrexate-induced acute encephalopathy.

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