EEG with extreme delta brush in young female with methotrexate neurotoxicity supports NMDA receptor involvement

作者：Schmidt Li**eth Samso^*; Kjaer Troels W; Schmiegelow Kjeld; Born Alfred Peter

来源：European Journal of Paediatric Neurology, 2017, 21(5): 795-797.

DOI：10.1016/j.ejpn.2017.05.008

• EEG
• Neurotoxicity
• NMDA receptor
• Extreme delta brush
• Methotrexate
• ALL

Sub-acute neurotoxicity is a well-known complication to high-dose and intrathecal methotrexate (MTX) treatment of children with leukemia. Symptoms can be treated safely by dextromethorphan, a non-competitive antagonist to N-methyl-D-aspartic acid receptor (NMDAR). In a female with subacute MTX neurotoxicity, we observed an electroencephalographic (EEG) with extreme delta brush. Extreme delta brush is an EEG pattern previously described in patients with NMDAR autoimmune encephalitis. The observations suggest that the mechanism of this neurotoxicity may be mediated by the NMDAR. Furthermore, extreme EEG delta brush should suggest a diagnosis of MTX associated subacute neurotoxicity.

• 出版日期2017-9