High-dose Cytarabine-related Toxic Encephalopathy with Multiple Cerebral Lesions in the Successful Treatment of Burkitt Lymphoma

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Chemotherapy drugs used in the treatment of leukemia and lymphoma can occasionally cause side effects.We present here a rare case of neurotoxicity that occurred after high-dose cytarabine (HiDAC) administration.A 13-year-old girl presented with right eye diplopia while receiving the high-risk non-Hodgkin lymphoma (NHL)-Berlin-Frankfurt-Münster 95 chemotherapy protocol.Magnetic resonance imaging (MRI) screening revealed four new parenchymal lesions, none of which showed contrast enhancement.The patient underwent a detailed evaluation for diplopia.Neurotoxicity occurred after the first HiDAC administration in our 13-year-old patient.Cytarabine is one of the key agents in the treatment of NHL, but complications of cytarabine toxicity include seizures, ataxia, and even death.The patient was treated with pulsed methylprednisolone for three days, which was then tapered and discontinued.A followup brain MRI performed at the end of the month showed that the lesions had reduced by more than 90%.This case highlights the importance of recognizing cytarabine-induced neurotoxicity, especially in pediatric patients undergoing intensive chemotherapy.Early diagnosis and prompt management can lead to significant clinical improvement and radiological resolution.