Four cases of paraplegia seen after intrathecal administration of MTX in three cases of acute lymphoblastic leukemia and one case of Burkitt's lymphoma are discussed, and cases from the literature are reviewed. Paraplegia developed one to three weeks after the administration of MTX. In addition to the paraplegia, two patients developed incontinence and encopresis, one anesthesia and another hyperesthesia. While some researchers relate the toxic effect of intrathecal MTX to its being administered with a preservative, others relate it to the patient's hypersensitivity or to the fact that it has been administered in conjunction with radiotherapy or intravenous MTX.

Keywords: acute lymphoblastic leukemia (ALL), intrathecal (IT), methotrexate (MTX), paraplegia