Progressive paresthesia and weakness after intrathecal chemotherapy.

A 53-year-old woman was diagnosed with acute lymphoblastic leukemia (ALL) confirmed by bone marrow biopsy to be pre-B ALL. The patient underwent a hyperfractionated cyclophosphamide, doxorubicin, vincristine, and dexamethosone (hyper-CVAD) regimen, except the doxorubicin was withheld. She received two intrathecal injections of cytarabine and methotrexate and two months later presented to Tulane University Hospital with paresthesias and weakness causing her to be wheelchair bound.