Reversible spastic paraparesis induced by high-dose intravenous methadone.
High doses of parenteral opioids can cause multifocal myoclonus and seizures. Spasticity has been reported in patients receiving intraspinal opioids. In this article, we describe a patient who developed reversible spastic paraparesis with prominent extensor spasms in the legs while receiving an infusion of intravenous methadone at 100 mg/hr. We discuss clinical presentation and possible pathophysiologic mechanisms of opioid side effects on the somatic motor system.
Manfredi
P L
PL
Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. manfredp@mskcc.org
Gonzales
G R
GR
Payne
R
R