Capecitabine-induced leukoencephalopathy involving the bilateral corticospinal tracts

Authors

  • Mark Bangwei Tan
  • Louis Elliott McAdory

DOI:

https://doi.org/10.3941/jrcr.v10i3.2686

Keywords:

Capecitabine induced leukoencephalopathy, corticospinal tracts, capecitabine toxicity, drug-induced leukoencephalopathy, corpus callosum

Abstract

An 80 year old lady with a history of metastatic sigmoid carcinoma presented with expressive dysphasia and unsteady gait 4 days after commencement of adjuvant capecitabine chemotherapy. MRI demonstrated restricted diffusion and T2/FLAIR hyperintensity involving the course of the bilateral corticospinal tracts, the corpus callosum and the middle cerebellar peduncles. Discontinuation of chemotherapy lead to symptom resolution in 2 days; repeat MRI at 2 months demonstrated reversal of the diffusion changes and improvement of the previous T2W/FLAIR hyperintensity. This report describes the first case of capecitabine induced leukoencephalopathy causing restricted diffusion along the corticospinal tracts, which should be differentiated from other entities that involve the corticospinal tracts (i.e. amyotrophic lateral sclerosis (ALS), primary lateral sclerosis (PLS), hypoglycemic coma, etc.)

Author Biographies

Mark Bangwei Tan

Resident, Department of Diagnostic Radiology, Singapore General Hospital

Louis Elliott McAdory

Consultant, Department of Diagnostic Radiology, Singapore General Hospital
Journal of Radiology Case Reports March 2016 issue - Cover page: A Rare Triad of Giant Occipital Encephalocele with Lipomyelomeningocele, Tetralogy of Fallot, and Situs Inversus by Arie Franco et al.

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Published

2016-03-28

Issue

Vol. 10 No. 3 (2016)

Section

Neuroradiology

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