Booklet for Hemato-Oncologists
Case 9 (A, B) - Seizures without other neurological signs in a 4-year old boy, without CNS involvement at diagnosis, during the second course of HD-MTX. No bleeding
Child, 4 years old, male, affected by ALL, no CNS involvement at diagnosis. 2 days after second course of HD-MTX (2 - 5 gr/m²) without Ara-C he developed seizures without any other neurological signs. No bleeding occurred.
A - What is your first choice sequential diagnostic procedure?
1. Fundoscopie- Study of spinal fluid proteins (brain barrier (BB) damage index) – cCT/cMR Scan – EEG
2. cCT/cMR Scan - EEG - BB-Index
3. PLT Count – cCT/cMR Scan - EEG
4. EEG – cCT/cMR Scan - Fundus Oculi
5. BB Index - PLT Count - EEG
B - Which drugs can induce seizures?
1. HD-MTX (> 1 gr/m²)
2. HD-ARA-C (> 1 gr/m²)
3. Conventional ARA-C dose (75-100 mg/m²)
4. Triplet (MTX - ARA C - Methylprednisolone) IT therapy
5. All the above
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