A fatal case of spongiform leukoencephalopathy linked to "chasing the dragon".
BACKGROUND
"Chasing the dragon" involves placing heroin on aluminum foil, heating it from below with a flame, and inhaling the pyrolysate through a straw. It has rarely been associated with the development of a progressive spongiform leukoencephalopathy.


METHODS
A 43-year-old woman presented with 2 weeks of bizarre behavior, forgetfulness, and slowed speech and movements. Serum, cerebrospinal fluid, and head computed tomography (CT) scan were normal. The patient progressed to coma and expired during week 4 of hospital admission. The family confirmed that she "chased the dragon." Cause of death at post mortem examination was spongiform leukoencephalopathy.


CONCLUSIONS
The diagnosis of heroin pyrolysate-induced spongiform leukoencephalopathy should be considered in a patient with a history of "chasing the dragon" and neurobehavioral changes, including confusion, apathy, cerebellar signs, and motor restlessness.
Long
Heather
H
New York City Poison Control Center, New York, New York, USA. heather.long@mindspring.com
Deore
Kimberly
K
Hoffman
Robert S
RS
Nelson
Lewis S
LS
D000328:Adult; D001519:Behavior; D001921:Brain / Q000473:pathology; D017825:Canavan Disease / Q000139:chemically induced* / Q000473:pathology / Q000523:psychology; D003128:Coma / Q000139:chemically induced / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D014057:Tomography, X-Ray Computed