What question did this study set out to answer?

To document a rare presentation of isolated cerebellar leukoencephalopathy induced by long-term oral methotrexate therapy.

August 16, 2026Arquivos de Neuro-PsiquiatriaOpen Access

Isolated oral methotrexate-induced cerebellar leukoencephalopathy: a rare and underrecognized imaging pattern

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Authors

ASAaliyah Shaikh ASAbdulrahman Kareem Sidani KAKevin J. Abrams

Discussion

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Overview

Case report demonstrates reversible cerebellar leukoencephalopathy caused by oral methotrexate in an elderly leukemia patient, highlighting the importance of drug discontinuation for recovery.

Key Points

To document a rare presentation of isolated cerebellar leukoencephalopathy induced by long-term oral methotrexate therapy.
Clinical and neuroimaging evaluation of an 86-year-old male with T-cell large granular lymphocytic leukemia presenting with progressive ataxia, imbalance, and altered mental status (N=1).
Brain CT and multimodal MRI assessment—including FLAIR, T2-weighted, diffusion-weighted imaging, ADC maps, and postcontrast sequences—alongside exclusion of alternative infectious, metabolic, and neoplastic causes.
Treatment via methotrexate discontinuation with clinical assessment and follow-up brain MRI at four months.
Initial neuroimaging identified bilateral, symmetric vasogenic edema in the deep cerebellar white matter and middle cerebellar peduncles sparing the dentate nuclei, with no restricted diffusion or enhancement.
Discontinuation of methotrexate yielded marked neurological symptom improvement and near-complete radiological resolution of vasogenic edema at four months, with minor residual cavitation.

Cite This Study

Shaikh et al. (2026) studied this question.

synapsesocial.com/papers/6a81796af2fb91fc834ac89a https://doi.org/10.1055/s-0046-1827043

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August 16, 2026Arquivos de Neuro-PsiquiatriaOpen Access

Isolated oral methotrexate-induced cerebellar leukoencephalopathy: a rare and underrecognized imaging pattern

View Full Paper

Ask AI

Bookmark

Authors

ASAaliyah Shaikh ASAbdulrahman Kareem Sidani KAKevin J. Abrams

Discussion

Member takes

Overview

Case report demonstrates reversible cerebellar leukoencephalopathy caused by oral methotrexate in an elderly leukemia patient, highlighting the importance of drug discontinuation for recovery.

Key Points

To document a rare presentation of isolated cerebellar leukoencephalopathy induced by long-term oral methotrexate therapy.
Clinical and neuroimaging evaluation of an 86-year-old male with T-cell large granular lymphocytic leukemia presenting with progressive ataxia, imbalance, and altered mental status (N=1).
Brain CT and multimodal MRI assessment—including FLAIR, T2-weighted, diffusion-weighted imaging, ADC maps, and postcontrast sequences—alongside exclusion of alternative infectious, metabolic, and neoplastic causes.
Treatment via methotrexate discontinuation with clinical assessment and follow-up brain MRI at four months.
Initial neuroimaging identified bilateral, symmetric vasogenic edema in the deep cerebellar white matter and middle cerebellar peduncles sparing the dentate nuclei, with no restricted diffusion or enhancement.
Discontinuation of methotrexate yielded marked neurological symptom improvement and near-complete radiological resolution of vasogenic edema at four months, with minor residual cavitation.

Cite This Study

Shaikh et al. (2026) studied this question.

synapsesocial.com/papers/6a81796af2fb91fc834ac89a https://doi.org/10.1055/s-0046-1827043

View Full Paper

Ask AI

Bookmark