Akademik Veri Yönetim Sistemi
16th European Paediatric Neurology Society Congress, Munich, Almanya, 8 - 12 Temmuz 2025, ss.901, (Özet Bildiri)
Objective: MTX-induced acute encephalopathy due to methotrexate (MTX), which is frequently used in the treatment of childhood acute lymphoblastic leukemia (ALL), presents with a wide range of clinical findings, including altered mental status, stroke-like symptoms, seizures, and headache. MTXinduced stroke-like neurotoxicity is difficult to distinguish clinically and radiologically from acute ischemic stroke. Herein, we report 5 patients previously with ALL who presented with confusion, loss of muscle strength, paresthesia, and seizures after MTX treatment, which clinically and radiologically mimic stroke-like symptoms, and were diagnosed with MTX-induced encephalopathy. Case Series: Five patients (aged 10 to 17 years) receiving chemotherapy for ALL were studied. All patients had focal or generalized muscle weakness and paresthesia; three had seizures, one had aphasia, one had central facial palsy, and one had dystonia. Brain magnetic resonance imaging showed T2/FLAIR hyperintensity and diffusion restriction in the centrum semiovale in all patients. Two patients were treated with Ca-folinate and two with leucoverin. Complete recovery was observed in three patients within 5-10 days and in one patient within 24 hours. One patient recovered with paraparesis. Conclusion: MTX-induced encephalopathy, one of the stroke mimics, should be considered as a potential factor in patients with ALL presenting with stroke-like symptoms (hemiparalysis, facial palsy, confusion, and seizures), and it is important to recognize these cases and avoid unnecessary thrombolytic and/or anticoagulant treatment.