Nine‐hundred‐eighty‐nine patients with diagnosis of lymphoma were studied. Forty‐six cases (4.6%) had compressions of the spinal cord or roots. Forty‐two patients (4.2%) had Herpes zoster virus infections, which in 6 cases were of disseminated type. The major predisposing factors for infection were: advanced stage of lymphoma, previous systemic chemotherapy and splenectomy. Toxic polyneuropathy secondary to chemotherapy was found in 39 patients (3.9%). In 14 cases, the polyneuropathic symptoms were the main complaint (Group 1), while in the remaining 25 cases the diagnosis was made during neurological consultations because of unrelated symptoms (Group 2). Both groups did not have significant differences in the total dose of chemotherapy received. The electrophysiological studies showed an axonal neuropathy in both groups. The discontinuation of chemotherapy was found to be a limiting factor in the appearance of neuropathic symptoms. Other less frequent forms of involvement were: compression of peripheral nerves or nerve plexi from lymphadenopathies (3 cases), radiation myelopathy (1 case), and Guillain‐Barré Syndrome associated with Hodgkin's Lymphoma (1 case).

I. RAVERA, ROBERTOEP. SICA RESUMEN -La amiodarona (AMD) es una droga antiarrítmica cuyos efectos adversos pueden comprometer el sistema nervioso central y periférico. La aparición de un síndrome cerebeloso es infrecuente. Se presenta un paciente masculino de 56 anos de edad que desarolla un síndrome pancerebeloso de 4 meses de evolución, que revierte luego de la suspension de la AMD. El cuadro reaparece meses mas tarde luego de un período de automedicacion con la droga. Los mecanismos tóxicos por los cuales la AMD afecta al cerebelo permanecen inciertos. Esta droga de amplia difusión en nuestro medio, como otros antiarrítmicos, posee efectos sobre el sistema nervioso que deben ser tenidos en cuenta a fin de poder detectarlos precozmente.PALABRAS-LLAVE: síndrome cerebeloso, amiodarona.Cerebellar syndrome by amiodarone SUMMARY -Amidarone (AMD) is an antiarrhytmic drug with side effects on the nervous system. Cerebellum is seldom involved. We describe the case of a 56 years old male patient with a history of 4 month of cerebellar involvement characterized by gait unstadiness, ataxia, nistagmus and vertigo. He was on treatment with AMD because of ventricular arrythmia. The cerebellar syndrom progressively disappeared after drug whitdrawal and he was symptoms-free 4 months later. Similar symptoms appeared after another one month of automedication with the same drug. Structural lesions, metabolic, nutritional deficiencies or toxics were excluded. Mechanisms of cerebellar toxicity of AMD are yet unknown. The knowledge of the toxic effects of this drug, widely used in our country, would allow its early recognition.KEY WORDS: cerebellar syndrome, amiodarone.La amiodarona (AMD) es una droga de uso frecuente en nuestro medio para el tratamiento de arritmias ventriculares y supraventriculares 10 . Sus efectos adversos sistemicos mas comunes son: hipertiroidismo, hipotiroidismo, depósitos corneales, fibrosis pulmonar, fotosensibilidad y aumento de las enzimas hepáticas 1,4 . Según las diferentes series, entre 20 y 54% de los pacientes que reciben AMD pueden presentar efectos colaterales sobre el sistema nervioso central y periférico 1,4 . El mas frecuente de ellos es la aparición de temblor postural, menos frecuentemente se describen trastornos en la marcha, parkinsonismo, distaxia de miembros, neuropatía y nistagmus 1,3 . Presentamos un paciente de 56 anos de edad, que desarrollo un síndrome pancerebeloso en relación a la administración de AMD, que remitió luego de la suspensión del fármaco. CASOFG, paciente de 56 anos de edad, de sexo masculino que, a raíz de una arritmia ventricular, inicia tratamiento con AMD, en dosis de 600 mg/dia. Tres meses mas tarde comienza con vértigo e inestabilidad progresiva para

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Nine-hundred-eighty-nine patients with lymphoma were studied. Fifty-three cases (5.3%) had lymphomatous craniocerebral infiltration. The principal factors of risk for this complication were: advanced stage of the lymphoma (III or IV), diffuse histiocytic, diffuse poorly differentiated lymphocytic, or mixed cellularity lymphoma histological type, bone marrow involvement, and previous systemic chemotherapy. Thirty-two per cent of the cases of meningeal lymphomatous infiltration were asymptomatic and represented autopsy findings. CT-scan was an useful test to detect brain focal parenchymatous infiltration, as opposed to meningeal infiltration. Mean survival time in patients with lymphomatous meningeal infiltration was 4.3 months, following the combined use of systemic chemotherapy, radiation therapy and intrathecal methotrexate. Two cases had primary cerebral lymphoma, although without associated immunodeficiency. Twenty patients (2%) had intracranial hemorrhage, in clear relationship with platelet alterations. Fifteen patients (1.5%) had CNS infection, caused by common bacteria or opportunistic agents. In 7 cases, the diagnosis was made at autopsy. Thirty-six autopsies were performed. In 8 cases (22%), pathologic findings such as, demyelination, microcalcifications, coagulative necrosis, or gliosis, suggested complications from treatment.

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