Acute and sub-acute neurological toxicity in children treated for acute lymphoblastic leukemia

•We describe clinical presentations of neurological toxicity, phases of treatment and patients’ outcome.•In 20th years, 1,379 patients were diagnosed and treated as ALL at the Hospital de Pediatría J. P. Garrahan.•Methotrexate-induced leukoencephalopathy was the most frequent toxic neurological event.•Seizure is the main symptom, followed by focal motor deficit.•Early phase of treatment presented an increased risk of developing neurotoxicity.