恶性肿瘤病人出现中枢神经系统(CNS)的体征和症状时,常常考虑是肿瘤向颅内转移。本文报道2例恶性肿瘤病人出现意识障碍,逐步发展为无动性缄默(Akinetic Mutism AM),并非肿瘤颅内转移,而是由于使用了氟尿嘧啶(5—Fu)的衍生物所致。停药后,病情得到恢复,CT 扫描也支持这种可逆性的AM 应该归因于5—Fu 衍生物引起的白质脑病。 Malignant tumor patients appear when the central nervous system (CNS) signs and symptoms, often considered tumor metastasis to the brain. This article reports two cases of malignant tumor patients with disturbance of consciousness, and gradually developed into the silent (Akinetic Mutism AM), not intracranial tumor metastasis, but due to the use of fluorouracil (5-Fu) derivatives. After discontinuation, the condition was restored and CT scanning also supported this reversible AM ​​due to leukoencephalopathy caused by 5-Fu derivatives.