Open AccessMethotrexate induced leucoencephalopathy: A stroke mimic
Author(s) -
Tushar Divakar Gosavi,
Mahyudin Ahmad,
Lai-Heng Lee,
Siew Hoon Lim
Publication year - 2013
Publication title -
annals of indian academy of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.427
H-Index - 31
eISSN - 1998-3549
pISSN - 0972-2327
DOI - 10.4103/0972-2327.116922
Subject(s) - medicine , methotrexate , thrombolysis , stroke (engine) , lymphoblastic leukemia , leukoencephalopathy , incidence (geometry) , acute stroke , pediatrics , intensive care medicine , surgery , magnetic resonance imaging , leukemia , tissue plasminogen activator , radiology , myocardial infarction , mechanical engineering , physics , optics , engineering
With increasing usage of thrombolysis in the treatment of acute ischemic strokes within 4.5- hour window, it is becoming more important to recognize stroke mimics. Though the incidence of stroke mimics being thrombolysed is less than 3%, it is essential to diagnose them so as to avoid wrong thrombolytic treatment which carries potential complications of bleeding. We describe the case of a 17 year old girl with acute lymphoblastic leukemia, who developed stroke like episodes on two consecutive challenges with a chemotherapeutic regime which included intravenous and intrathecal methotrexate. She had MRI changes consistent with acute ischemic stroke on both occasions. Her deficits recovered completely and spontaneously, as did the MRI changes. She did not have any further episodes when methotrexate was excluded from the chemotherapeutic regime.