We report a 35-year-old woman who suddenly developed left hemiparesis and dysarthria at 13 days after treatment with intrathecal and intravenous methotrexate for intravascular large B cell lymphoma with possible central nervous system infiltration. Seven hours after onset, she developed further right hemiparesis and aphasia. However, the majority of neurologic symptoms disappeared spontaneously and completely by 34 hours. We also recorded the dynamic progression and regression of abnormal signals in the bilateral corona radiata on diffusion-weighted imaging, in parallel with neurologic symptoms. The rapid reversal of MR abnormalities and neurologic symptoms allowed us to diagnose methotrexate encephalopathy, and exclude intravascular large B cell lymphoma recurrence and regular brain infarction. The case provides new data on the dynamic changes of abnormal signals on magnetic resonance imaging in methotrexate encephalopathy over a short recovery time.
|Journal||Journal of Stroke and Cerebrovascular Diseases|
|Publication status||Published - Nov 2018|
All Science Journal Classification (ASJC) codes
- Clinical Neurology
- Cardiology and Cardiovascular Medicine