Paraplegia following intrathecal chemotherapy

Abstract

A case report and review of the literature of paraplegia following intrathecal chemotherapy with methotrexate and cytosine arabinoside is presented. Autopsy identified damage to the spinal nerve roots within the subarachnoid space, which accounted for the neurologic deficit. The only substances common to both chemotherapeutic agents were their preservatives, methylhydroxybenzoate and benzyl alcohol, which were used, in the diluent. Prolonged exposure to these preservatives is known to cause severe neurotoxicity. Though the specific agent responsible for paraplegia following intrathecal chemotherapy is unknown, there is evidence to suggest that the preservatives rather than the therapeutic agents themselves are responsible. Copyright © 1972 American Cancer Society