Ifosfamide-induced encephalopathy and movement disorder.

Ifosfamide is a widely used chemotherapeutic agent for the treatment of a broad spectrum of solid tumors. CNS toxicity is a well-described side effect of ifosfamide, but the mechanism of ifosfamide-induced neurotoxicity remains poorly defined. We present two pediatric cases of hemiballismic limb movements in the setting of ifosfamide-associated encephalopathy. To our knowledge, there have been no prior reports of ifosfamide-induced hemiballism in pediatric patients. One of our patient's encephalopathy and abnormal movements may have improved after the administration of methylene blue and thiamine.