Methotrexate-induced myelopathy mimicking subacute combined degeneration of the spinal cord
Related Experiment Video
Updated: May 11, 2026

Sagittal Plane Kinematic Gait Analysis in C57BL/6 Mice Subjected to MOG35-55 Induced Experimental Autoimmune Encephalomyelitis
Published on: November 4, 2017
Tushar Gosavi1, Colin Phipps Diong, Shih-Hui Lim
1Department of Neurology, National Neuroscience Institute and Singapore General Hospital, Outram Road, Singapore 169608, Singapore. tgosavi@hotmail.com
Abstract:
Methotrexate (MTX), a folate antagonist, is widely used to treat hematological malignancies. Although it is known to cause myelopathy, little is known about the pathophysiology and natural history of this myelopathy. We describe a 42-year-old woman with acute lymphoblastic leukemia who was treated with chemotherapy consisting of intrathecal MTX who developed a progressive myelopathy. The myelopathy mimicked, radiologically, subacute combined degeneration (SACD) of the spinal cord. This myelopathy mimicking SACD could be explained by the folate antagonism of MTX. The progressive clinical signs and serial MRI in this patient further our understanding of the natural progression of this myelopathy.
Related Concept Videos
Secondary Spinal Cord Injury llI: Pathophysiology
Multiple Sclerosis l: Introduction
Degenerative Disc Disease ll: Pathophysiology
Myasthenia Gravis: Diagnostic Tests
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
