A Delayed Methadone Encephalopathy: Clinical and Neuroradiological Findings

Zanin, Anna; Masiero, Susanna; Severino, Mariasavina; Calderone, Milena; Dalt, Liviana Da; Laverda, Anna Maria

doi:10.1177/0883073809343318

Cited by 50 publications

(45 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 Methodone overdose in children in the US is significant as well. 19,37 In our case, the overdose was reportedly related to the child finding and ingesting the addicted mother's prescription drugs hidden between the seats in the car.…”

Section: Discussion Clinical Presentationsmentioning

confidence: 67%

“…However, when it does occur, the neurological effects and sequelae can result in significant long-term morbidity. 37 A multitude of toxic effects of opioids have been reported, including systemic and CNS effects. 13,37 The most common symptoms were varying degrees of CNS depression, suppression of the respiratory center with resultant hypercapnia, and respiratory acidosis with miosis.…”

Section: Discussion Clinical Presentationsmentioning

confidence: 99%

“…37 A multitude of toxic effects of opioids have been reported, including systemic and CNS effects. 13,37 The most common symptoms were varying degrees of CNS depression, suppression of the respiratory center with resultant hypercapnia, and respiratory acidosis with miosis. 13,36 Methadone intoxication in children can present similar to other narcotic intoxications, with dosedependent depression of the CNS.…”

Section: Discussion Clinical Presentationsmentioning

confidence: 99%

“…The cerebellum may not be very edematous, and hydrocephalus may not be present on the initial radiological studies. 21,37 Significant cerebellar edema can develop within hours, and serial clinical and radiological evaluations may be needed. Given that these patients are often comatose with a compromised neurological examination, we recommend routine serial CT scanning, especially in the first 48 hours.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Opioid overdose in a child: case report and discussion with emphasis on neurosurgical implications

Reisner

Hayes

Holland

et al. 2015

PED

View full text Add to dashboard Cite

In environments in which opioids are increasingly abused for recreation, children are becoming more at risk for both accidental and nonaccidental intoxication. In toxic doses, opioids can cause potentially lethal acute leukoencephalopathy, which has a predilection for the cerebellum in young children. The authors present the case of a 2-year-old girl who suffered an accidental opioid overdose, presenting with altered mental status requiring cardiorespiratory support. She required emergency posterior fossa decompression, partial cerebellectomy, and CSF drainage due to cerebellar edema compressing the fourth ventricle. To the authors’ knowledge, this is the first report of surgical decompression used to treat cerebellar edema associated with opioid overdose in a child.

show abstract

Section: Discussion Clinical Presentationsmentioning

confidence: 67%

Section: Discussion Clinical Presentationsmentioning

confidence: 99%

Section: Discussion Clinical Presentationsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Opioid overdose in a child: case report and discussion with emphasis on neurosurgical implications

Reisner

Hayes

Holland

et al. 2015

PED

View full text Add to dashboard Cite

show abstract

“…This is not an isolated phenomenon since a delayed spongiform leukoencephalopathy has been described in an accidental methadone overdose in a child and in an overdose in an IV heroin drug user. 7,8 The radiologic findings differ from some cases of heroin-induced TLE since the hypointensities found on T2 fluid-attenuated inversion recovery were supratentorial and there was no cerebellar involvement; however, there is a case report of methadone-induced TLE resulting in diffuse T2 hyperintensities with sparing of cortical U-fibers. 9 Moreover, periventricular white mater changes have been documented by Kriegstein et al 3 Even though there is some uncertainty about the method of heroin ingestion and differences in the radiologic findings of heroin leukoencephalopathy, the patient history and physical indicate that opioid use resulted in a delayed onset of TLE.…”

Section: Discussionmentioning

confidence: 98%

Mystery Case: A 48-year-old woman with bizarre behavior, neurologic symptoms, and progressive decline

et al. 2018

View full text Add to dashboard Cite

Section 1A 48-year-old woman with an alcohol use disorder presented with a subacute onset of altered mental status. Two months prior to presentation, the patient recreationally used morphine, oxycodone, and heroin over the span of 1 week. At the end of this 7-day period, she experienced an episode of lethargy for approximately 24 hours and continued to be difficult to arouse during the following 2 days; however, she did not seek medical attention. She returned to her baseline functional status and remained asymptomatic until 3 weeks later, when she fell and hit her head, initially resulting in a headache. One day later, she began exhibiting bizarre behavior that gradually increased in severity over the following month. She began by sleeping with a recently deceased relative's ashes and emotional labiality and progressed to brushing her teeth with a comb, showering while dressed, undressing and then going outside, and not recognizing family members. Her husband brought her to the hospital for further evaluation.Her neurologic examination demonstrated that she was only oriented to self and had poor comprehension due to an inability to follow commands or respond appropriately to questions. Moreover, she demonstrated apraxia, aphasia, and selective mutism. Additional neurologic findings included patellar hyperreflexia, a palmomental reflex, and a wide-based gait. The remainder of the examination was limited by patient participation.

show abstract

Suppressor capacity of iron nanoparticles biosynthesized using Salvia chloroleuca leaf aqueous extract on methadone‐induced cell death in PC12: Formulation a new drug from relationship between the nanobiotechnology and neurology sciences

Ahmeda

Zangeneh

Mansooridara

et al. 2020

Applied Organom Chemis

View full text Add to dashboard Cite

Metallic nanoparticles have gained significant attention in the area of biomedical technology. Because of its high surface area, metallic nanoparticles are being widely used in various fields including the medical and engineering sciences. One of the valuable applications of metallic nanoparticles especially copper, zinc, and iron nanoparticles is increasing the physiological function of central nervous system. Besides, Iranian people are using the Salvia chloroleuca for neuroprotective properties. In the present research, iron nanoparticles were biosynthesized by S. chloroleuca leaf aqueous extract as reducing and stabilizing agents. Also, we revealed the protective effect of FeNPs in methadone‐treated PC12 cells. FeNPs were characterized and analyzed using common nanotechnology techniques including FT‐IR, UV–Vis. spectroscopy; EDS, TEM, and FE‐SEM. TEM and FE‐SEM images revealed a uniform spherical morphology for FeNPs. In the biological part of the current study, the both treatments of FeNPs significantly (p ≤ 0.01) reduced the cell cytotoxicity and cell death index as well as increased the cell viability and cell proliferation in methadone‐treated PC12 cells. In these treatments, mitochondrial membrane potential significantly (p ≤ 0.01) increased compared to methadone‐induced PC12 cells. DPPH free radical scavenging test was did to evaluate the antioxidant potentials of FeCl3, S. chloroleuca, and FeNPs. DPPH test indicated similar antioxidant activities for S. chloroleuca, FeNPs, and butylated hydroxytoluene. In current experiment, we concluded that iron nanoparticles biosynthesized by S. chloroleuca leaf aqueous extract suppressed methadone‐induced cell death in a dose‐dependent manner in PC12 cells.

show abstract

A Delayed Methadone Encephalopathy: Clinical and Neuroradiological Findings

Cited by 50 publications

References 14 publications

Opioid overdose in a child: case report and discussion with emphasis on neurosurgical implications

Opioid overdose in a child: case report and discussion with emphasis on neurosurgical implications

Mystery Case: A 48-year-old woman with bizarre behavior, neurologic symptoms, and progressive decline

Suppressor capacity of iron nanoparticles biosynthesized using Salvia chloroleuca leaf aqueous extract on methadone‐induced cell death in PC12: Formulation a new drug from relationship between the nanobiotechnology and neurology sciences

Contact Info

Product

Resources

About