Methadone-Induced Toxic Leukoencephalopathy: MR Imaging and MR Proton Spectroscopy Findings

Salgado, Rodrigo; Jorens, Philippe G.; Baar, Ingrid; Cras, Patrick; Hans, Guy; Parizel, Paul M.

doi:10.3174/ajnr.a1889

Cited by 53 publications

(44 citation statements)

References 13 publications

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“…No case showed complete recovery, clinically or radiologically. One 62-year-old woman made a gradual recovery from this syndrome following accidental methadone overdose 8. Also, a 37-year-old man had a good outcome following ingestion of methadone and diazepam, with no functional deficits at 2 years,9 having had extensive white matter hyperintensities on imaging.…”

Section: Discussionmentioning

confidence: 99%

Delayed toxic–hypoxic encephalopathy

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Delayed toxic–hypoxic encephalopathy

et al. 2013

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“…Methadone abuse has been reported to precede catatonia and extrapyramidal symptoms, with MRI images demonstrating extensive, symmetric signal-intensity abnormalities in deep white matter. These findings have been compared to the more familiar toxic leukoencephalopathy from heroin pyrosylate [66,67]. In the 1980s, "chasing the dragon," inhaling the thick white pyrosylate generated by heating heroin base on aluminum foil, was implicated in an unexplained spongiform encephalopathy in the Netherlands.…”

Section: Case Continuationmentioning

confidence: 99%

Case Files of the New York City Poison Control Center: Paradichlorobenzene-Induced Leukoencephalopathy

2010

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A 44-year-old man was brought to the emergency department by emergency medical services after he was discovered lying supine on his apartment floor. He was accompanied by his sister, who had decided to visit him after his absence from a family function. Worsening "bizarre" behavior had been noted by family members for 4 weeks, characterized by anorexia, social withdrawal, flat affect, and alogia. Prior to his illness, he was described as functional, independent, gainfully employed, and social.The patient had mild mental retardation and hypertension. There was no history of diagnosed psychiatric illness, although his family suspected pica. Medications included an unknown antihypertensive with which he was not compliant. He occasionally used marijuana and alcohol, without history of other abused drugs. The patient's sister reported significant weight loss over several months. There had been no apparent fevers, cough, vomiting, diarrhea, or convulsions. On physical examination, he appeared drowsy, was markedly cachectic, and emanated an atypical aromatic body odor. Initial vital signs were: blood pressure 154/90 mmHg, heart rate 98/min, respiratory rate 20/min, rectal temperature 37.4°C, and room air oxygen saturation 97%. Head, neck, chest, and abdominal examinations were unremarkable. He had dry, scaling, and ichthyotic skin. He was oriented to person and place, but not to time, date, or indication for hospitalization. Limited cranial nerve evaluation was normal. Pain and light-touch sensation were unaffected. Hyperreflexia (without clonus) and cogwheel rigidity were noted in both lower extremities; upper extremities were normal. Plantar reflexes were normal bilaterally. Muscle bulk, tone, and strength were normal. The patient was unable to stand without support and unable to ambulate, apparently due to impaired equilibrioception. He could follow simple one-step commands. He would speak a few words when asked simple questions, and he avoided eye contact.Serum electrolytes (sodium, potassium, chloride, calcium, and magnesium) and serum glucose were normal. Tests of hepatic and renal function were: AST 53

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“…Numerous other drugs of abuse have been associated with toxic leukoencephalopathy to a lesser extent. These include the psychoactive drug 2C-E "Europa" [15], oxycodone [24], and methadone [25,26].…”

Section: Discussionmentioning

confidence: 99%

Methylenedioxymethamphetamine (MDMA)-induced toxic leukoencephalopathy: a case report

Salem

Barton

Ali

et al. 2017

Psychiatry and Clinical Psychopharmacology

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In recent years, ecstasy has become a very popular recreational drug. To date, very little data is available regarding its toxic side effects. Specifically, reports relating ecstasy use to the clinical diagnosis of leukoencephalopathy are quite rare. In this report, we present an interesting case of a 33-year-old female with a recent history of ecstasy abuse who presented with delirium and cognitive impairment. In addition, we review published case reports that explore the connection between MDMA and leukoencephalopathy.ARTICLE HISTORY

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Methadone-Induced Toxic Leukoencephalopathy: MR Imaging and MR Proton Spectroscopy Findings

Cited by 53 publications

References 13 publications

Delayed toxic–hypoxic encephalopathy

Delayed toxic–hypoxic encephalopathy

Case Files of the New York City Poison Control Center: Paradichlorobenzene-Induced Leukoencephalopathy

Methylenedioxymethamphetamine (MDMA)-induced toxic leukoencephalopathy: a case report

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