Methotrexate‐induced stroke‐like neurotoxicity: Case report, 8 years of experience, and literature review

Methotrexate-Induced Stroke-Like Leukoencephalopathy

“…However, in some patients, treatments such as additional folic acid, leucovorin rescue, dexamethasone, aminophylline, and dextromethorphan have been used [1,4,9]. This syndrome is usually transient, and patients can achieve complete neurological recovery; however, chronic radiographic sequelae may persist, as observed in the present case [2,8,9]. For the patient in this case, follow-up MRI conducted at 5 months revealed patchy hyperintensity in the right frontal white matter, which did not correspond to the initial diffusion abnormality.…”

“…Its capacity to cross the blood-brain barrier and eliminate leukemic cells from the central nervous system makes MTX a critical component in the treatment of acute lymphoblastic leukemia (ALL) [1-3]. However, MTX can also cause adverse effects such as neurotoxicity, myelosuppression, mucositis, liver damage, and kidney failure [2,3]. Patients with leukemia may exhibit focal neurological deficits due to various conditions, including cerebral infarction, intracranial hemorrhage, and infection.…”