Apr 1, 1992

Cerebrospinal fluid exchange after intrathecal methotrexate overdose. A report of two cases

Acta Paediatrica
A M JakobsonP J Moe


Two patients aged 11 and four years, were accidentally given a 10-fold overdose of intrathecal methotrexate while being treated for malignant disease. Neither patient developed any signs of neurotoxicity and exchange of lumbar cerebro-spinal fluid was started 3 and 5 h later, respectively. In one of the patients, who received 120 mg of methotrexate intrathecally, 31% of the given dose was recovered during 2 h of cerebrospinal fluid exchange that was started 3 h after the accidental overdosage. No sequelae were observed in any of the patients. Cerebrospinal fluid exchange is safe and can be recommended in all cases of intrathecal methotrexate overdosage. Ventriculo-cisternal perfusion is not necessary in cases of a 10-fold overdose if the patient has no signs of acute neurotoxicity.

  • References8
  • Citations18


Mentioned in this Paper

Leukemia, Lymphocytic, Acute, L2
Malignant Disease
Spinal Puncture
Medication Error
Cerebrospinal Fluid
Lumbar Region
Sodium Chloride, (24)NaCl
Neoplasms, Second Primary
Methotrexate, (DL)-Isomer

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