Trigeminal neuralgia in acute lympblastic leukemia

Abstract

Cranial nerve involvements in leukemia are rare and generally associated with CNS relapse. A 12 year old girl was diagnosed as ALL L3 in our pediatric hematology department. Remission induction and 2400 cGay prophylactic cranial radiotherapy were administered. She was admitted with trigeminal neuralgia at the 7th month of maintenance. CSF investigations, bone marrow examinations and cranial CT were normal. The pain partially responded to carbamazepin and comletely resolved in a week after adding high dose methylprednisolone (HDMP) treatment. Reinduction completed with HDMP, L-asparaginase and high dose methotraxete and then, a new maintenance treatment was begun. First bone marrow relapse without CNS relapse was determined at 14th month of first complete remission. We concluded that trigeminal nerve involvement might be an extramedullary relapse site and the use of HDMP could be an effective part of the treatment in cranial nerve involvements.