Leucoencephalopathy after heroin inhalation. A case with partial regression of MRI lesions.
We report the case of a 41 year old patient who developed a severe cerebellar ataxia. MRI findings were suggestive of myelin damage with symmetrical involvement of the cerebellar hemispheres and, to a lesser extent, the decussation of the superior cerebellar peduncles, the corticospinal tracts and the centrum semiovale. He had been inhaling heroin for the last 5 years. Two years after stopping heroin, he showed clinical improvement with partial regression of the MRI lesions. MRI findings of leucoencephalopathy after heroin inhalation are well described in the literature, however longitudinal studies are rare. It is the purpose of this report to show that clinical and MRI features can be characteristic of this leucoencephalopathy and that regression of white matter lesions can be seen after heroin withdrawal.
Koussa
S
S
Division of Neurology, St Joseph University, Hôtel-Dieu de France Hospital, Beirut, Lebanon. koussalam@hotmail.com
Tamraz
J
J
Nasnas
R
R
D000280:Administration, Inhalation; D000328:Adult; D001927:Brain Diseases / Q000139:chemically induced* / Q000473:pathology*; D003932:Heroin / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects*; D019636:Neurodegenerative Diseases / Q000139:chemically induced* / Q000473:pathology*; D012074:Remission Induction
D009294:Narcotics; D003932:Heroin