• Internal medicine · Aug 2023

    Case Reports

    A Case of Methotrexate-induced Subacute Encephalopathy that Showed no Abnormalities on Magnetic Resonance Imaging Soon After Symptom Appearance.

    • Haruna Fujisawa, Yurika Mitsui, Kensuke Narukawa, Yukari Shirasugi, Shogo Komaki, Akihito Hao, Hideyuki Matsumoto, and Tsuyoshi Takahashi.
    • Division of Hematology, Mitsui Memorial Hospital, Japan.
    • Intern. Med. 2023 Aug 1; 62 (15): 224922522249-2252.

    AbstractA 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 high-intensity 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 MTX-induced encephalopathy.

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