Transient encephalopathy following high‐dose methotrexate

Lee, Acw; Li, C H; Wong, Yiu Chung

doi:10.1002/mpo.1339

Cited by 8 publications

(2 citation statements)

References 4 publications

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“…It is difficult to predict the onset of transient encephalopathy by monitoring the MTX concentration because the pharmacokinetics of MTX are not related to the frequency of episodes ( 5 ). Our patient's plasma MTX concentration returned to normal immediately after treatment with high-dose MTX ( Fig.…”

Section: Discussionmentioning

confidence: 99%

Methotrexate-induced Transient Encephalopathy in an Adolescent and Young Adult Patient with Acute Lymphoblastic Leukemia

et al. 2021

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A 17-year-old girl was diagnosed with acute lymphoblastic leukemia (ALL). After the administration of high-dose methotrexate (MTX) or intrathecal MTX, the patient experienced transient hemiparesis and motor aphasia. Diffusion-weighted magnetic resonance imaging showed a high-intensity lesion in the bilateral centrum semiovale, and a vasospasm was detected in the proximal segment of bilateral A1 on magnetic resonance angiography. Edaravone was administered, and leucovorin rescue treatment was continued; eventually, the patient's neurological symptoms completely resolved. This finding suggested that vasospasm might be a mechanism underlying MTX-induced transient encephalopathy in adolescent and young adult patients with ALL.

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Section: Discussionmentioning

confidence: 99%

Methotrexate-induced Transient Encephalopathy in an Adolescent and Young Adult Patient with Acute Lymphoblastic Leukemia

et al. 2021

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“…MTX-induced acute and subacute encephalopathy usually occur within two weeks after using MTX (4-7), and both intravenous and intrathecal MTX injections can cause it (3,(8)(9)(10). MTX-induced encephalopathy presents with stroke-like symptoms, such as disturbed consciousness, seizures, and speech disorders (2,8,11).…”

Section: Introductionmentioning

confidence: 99%

Methotrexate-induced Subacute Encephalopathy That Showed No Abnormalities on Magnetic Resonance Imaging Soon after Symptom Appearance

et al. 2023

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A 21-year-old woman was diagnosed with acute lymphoblastic leukemia. After the administration of intrathecal methotrexate (MTX), the patient experienced dysarthria and paralysis for one hour. Magnetic resonance imaging (MRI) performed one hour from the onset and just before symptoms disappeared revealed no abnormalities. The next day, the symptoms appeared again, and diffusion-weighed MRI revealed a highintensity area in the left frontal lobe. The patient was diagnosed with MTX-induced encephalopathy. This case suggested that MRI performed as soon as symptoms appear might show normal findings in MTXinduced encephalopathy.

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