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Updated: Sep 10, 2025

Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
Published on: July 4, 2007
Case of Acute Encephalopathy Associated With Montelukast
1Eastern Virginia Medical School, Macon and Joan Brock Virginia Health Sciences at Old Dominion University, Norfolk, VA.
Introduction:
Montelukast has been associated with neuropsychiatric adverse events including mood disorders, suicidality, and anxiety disorders. Studies have shown a possible association between montelukast and delirium; however, most of this research has been focused on children and adolescents.
Case Report:
A 59-year-old female was admitted for management of spinal osteomyelitis, psoas abscess, epidural abscess, and bacteremia. On hospital day 19, she had new onset of encephalopathy, and workup revealed no clear etiology. On hospital day 41, her home dose of montelukast was stopped, and her mentation improved over the next several days. This improvement in cognition was sustained even though other medical factors continued to fluctuate.
Discussion:
There were many factors that may have contributed to this patient's encephalopathy, but the temporal relationship between cessation of montelukast and improvement in her mentation suggests an association between this medication and her symptoms.
Conclusion:
We present a hospitalized patient with acute encephalopathy, which resolved after discontinuing montelukast.
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