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Ventral polyradiculopathy with pediatric acute lymphocytic leukemia
Author(s) -
Anderson Stephen C.,
Baquis George D.,
Jackson Anthony,
Monteleone Philip,
Kirkwood J. Robert
Publication year - 2002
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.1219
Subject(s) - medicine , nerve root , compound muscle action potential , myelopathy , polyradiculopathy , pleocytosis , anesthesia , acute lymphocytic leukemia , lumbosacral joint , magnetic resonance imaging , cerebrospinal fluid , polyneuropathy , electromyography , brachial plexus , cytarabine , nerve conduction study , spinal cord , pathology , surgery , chemotherapy , leukemia , radiology , nerve conduction , electrophysiology , lymphoblastic leukemia , psychiatry
A 3‐year‐old girl with acute lymphocytic leukemia (ALL) in remission developed lower extremity paraparesis and areflexia 15 days after receiving intrathecal methotrexate, cytarabine, and hydrocortisone. Cerebrospinal fluid protein was 107 mg/dl. Compound muscle action potential amplitudes were reduced, F waves were absent, and sensory conduction studies were normal. Needle electromyography (EMG) revealed reduced motor unit potential recruitment. Magnetic resonance imaging (MRI) showed lumbosacral ventral root enhancement. She was treated with intravenous immunoglobulin and slowly recovered. Nerve conduction and EMG abnormalities correlated with MRI root enhancement, facilitated early diagnosis, and distinguished this from a myelopathy or distal polyneuropathy. These findings could represent selective ventral nerve root vulnerability to intrathecal chemotherapy. A selective autoimmune process cannot be excluded. © 2002 John Wiley & Sons, Inc. Muscle Nerve 25: 106–110, 2002