Methotrexate-induced leukoencephalopathy presenting as stroke in the emergency department
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Updated: Jun 22, 2026
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Published on: November 26, 2013
Maria Teresa Cruz-Carreras1, Patrick Chaftari1, Anna Shamsnia1
1Department of Emergency Medicine The University of Texas MD Anderson Cancer Center Houston Texas.
Clinical Case Reports
|October 14, 2017
Abstract:
Methotrexate-induced leukoencephalopathy is to be considered as a potential etiology in any patient presenting with stroke-like symptoms after receiving methotrexate. One of our cases suggests that the method of administration of the methotrexate can be IV or intrathecal and still results in leukoencephalopathy.
Insights
Methotrexate-induced leukoencephalopathy can cause stroke-like symptoms in patients. This condition may occur regardless of whether methotrexate is administered intravenously or intrathecally.
Area of Science:
- Neurology
- Oncology
- Toxicology
Background:
- Methotrexate is a chemotherapy agent used in various cancers and autoimmune diseases.
- Leukoencephalopathy is a condition affecting the white matter of the brain.
Observation:
- Patients receiving methotrexate may present with stroke-like symptoms.
- Two cases of methotrexate-induced leukoencephalopathy were observed.
Findings:
- Methotrexate-induced leukoencephalopathy should be considered in patients with stroke-like symptoms post-methotrexate treatment.
- Leukoencephalopathy can result from both intravenous and intrathecal administration of methotrexate.
Implications:
- Clinicians should be aware of this potential adverse effect of methotrexate.
- Diagnostic considerations for stroke-like symptoms in patients on methotrexate should include leukoencephalopathy.
- Further research into the mechanisms and prevention of methotrexate neurotoxicity is warranted.
Keywords:
Acute lymphocytic leukemiafocal weaknessintrathecal methotrexatemethotrexate‐induced leukoencephalopathyneurotoxic side effectsMore Related Videos
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