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A girl with acute lymphoblastic leukemia in remission had two seizures during the maintenance phase of her treatment. Magnetic resonance imaging with angiography identified a superior sagittal sinus thrombosis as the likely explanation for her symptoms. Possible causes are considered, and previous reports of the neurotoxicity of agents used in the treatment of leukemia are reviewed.

though the drug had been stopped several years previously.4 More recently 25% of 60 patients given thalidomide to manage chronic discoid lupus erythematosus were reported to have developed thalidomide neuropathy5 and all eight patients given thalidomide for nodular prurigo and aphthous stomatitis were found to have a neuropathy.6 Despite warnings," thalidomide has been used for over 20 years to manage erythema nodosum leprosum, and Waters states that "thalidomide peripheral neuropathy has not yet been reported" in such patients.4 This statement requires clarification. Is it implying that neuropathy does not occur in patients with erythema nodosum leprosum given the drug or is it that Waters and leprologists who use thalidomide are unable to detect symptoms and signs of nerve damage?

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