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Leukoencephalopathy with brain stem and spinal cord involvement and high lactate (LBSL) include cerebral white matter, brain stem and spinal cord tract involvement on magnetic resonance imaging. Increased lactate levels on magnetic resonance spectroscopy (MRS) has been reported. In this case report, we describe a patient with LBSL and normal lactate levels on MRS. [ABSTRACT FROM AUTHOR]

Objective: Methotrexate (MTX)-associated neurotoxicity is an important clinical problem in cancer patients, but the mechanisms of MTX-induced neurotoxicity are not yet known exactly. The aims of this study were (1) to investigate the possible role of malondialdehyde (MDA), superoxide dismutase (SOD) enzyme, glutathione peroxidase (GSH-Px) and catalase (CAT) in the pathogenesis of MTX-induced neurotoxicity and (2) to determine whether there is a putative protective effect of caffeic acid phenethyl ester (CAPE) on MTX-induced neurotoxicity in the spinal cord, brainstem and sciatic nerve of rats. Materials and Methods: A total of 19 adult Wistar male rats were divided into three experimental groups. Group I, control group; Group II, MTX-treated group; and Group III, MTX + CAPE-treated group. MTX was administered to the MTX and MTX + CAPE groups intraperitoneally (IP) with a single dose of 20 mg/kg on the second day of the experiment. CAPE was administered to the MTX + CAPE group IP with a dose of 10 μmol/kg for 7 days. Results: In the sciatic nerve and spinal cord tissue, CAT and GSH-Px activities were increased in the MTX group in comparison with the control group. CAPE treatment with MTX significantly decreased CAT and GSH-Px activities in the neuronal tissues of rats in comparison with the MTX group. In the spinal cord and brainstem tissues, SOD activity in the MTX group was decreased in comparison with the control group, but in the sciatic nerve, there was no significant difference. In the spinal cord and brainstem of rats, SOD activity was increased in the CAPE + MTX group when compared with the MTX group. The level of MDA was higher in the MTX group than in the control group. CAPE administration with MTX injection caused a significant decrease in MDA level when compared with the MTX group. Conclusion: These results reveal that MTX increases oxidative stress in the sciatic nerve, spinal cord and brainstem of rats and that CAPE has a preventive effect on the oxidative stress via its antioxidant capacity. [ABSTRACT FROM AUTHOR]