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[Spectral EEG analysis in children treated with high-dose methotrexate]
Gan to Kagaku Ryoho. Cancer & Chemotherapy
|March 1, 1987
Summary
High-dose methotrexate (HD-MTX) can cause subclinical central nervous system (CNS) changes, detected by electroencephalogram (EEG). Serial EEGs may serve as an early indicator for detecting leukoencephalopathy in at-risk patients.
Area of Science:
- Neuroscience
- Oncology
- Pharmacology
Background:
- High-dose methotrexate (HD-MTX) is a chemotherapy agent used for osteogenic sarcoma and malignant lymphoma.
- Leucovorin rescue is administered to mitigate HD-MTX toxicity.
- Central nervous system (CNS) involvement is a potential concern with HD-MTX therapy.
Observation:
- Serial electroencephalogram (EEG) monitoring was performed on two patients receiving HD-MTX therapy.
- EEG analysis focused on occipital basic activity and power spectrum.
- Patients had no pre-existing CNS involvement or clinical symptoms of impairment.
Findings:
- A transient, statistically significant slowing of EEG activity was observed at 48 hours post-MTX initiation.
- This included a drop in dominant frequency and a decreased alpha/theta ratio.
- EEG changes normalized within one week, with no clinical CNS impairment noted.
Implications:
- EEG alterations may indicate subclinical CNS impairment during HD-MTX therapy.
- Serial EEGs could serve as an early detection tool for leukoencephalopathy in high-risk patients.
- This highlights the utility of neurophysiological monitoring in chemotherapy regimens.