Accidental intrathecal vincristine administration. Report of a case

A case is described of accidental intrathecal administration of vincristine, with detailed clinical observations over a 17-day period. The clinical picture resembled that seen with toxicity from intravenously administered vincristine, but was rapidly progressive and resulted in death. The onset was characterised by opisthotonos, followed by ascending paralysis and finally bulbar and cerebral involvement. The specific changes in the brain at autopsy were masked by those due to prolonged artificial respiration prior to death. The accidental drug administration occurred owing to procedural errors, which can be avoided by strict attention to rules.