A delayed methadone encephalopathy: clinical and neuroradiological findings.
Several studies on opiates demonstrated that selected brain areas as cerebellum and limbic system have the greatest density of opioid receptors. Recently, few cases of severe cerebellitis following methadone poisoning have been reported in children. We present the case of a 30-month-old girl who developed a delayed encephalopathy after methadone intoxication. She was admitted to our emergency department in coma, and after naloxone infusion, she completely recovered. Five days after intoxication, she developed psychomotor agitation, slurred speech, abnormal movements, and ataxia despite a negative neuroimaging finding. A repeat magnetic resonance imaging (MRI) performed 19 days after the intoxication for persistent symptoms showed signal abnormalities in the temporomesial regions, basal ganglia, and substantia nigra. To our knowledge, this is the first report of these delayed MRI findings associated with synthetic opioid intoxication.
Zanin
Anna
A
Paediatric Emergency Unit, Paediatric Department, University of Padua, 35100 Padua, Italy. anna.zanin@unipd.it
Masiero
Susanna
S
Severino
Maria Savina
MS
Calderone
Milena
M
Da Dalt
Liviana
L
Laverda
Anna Maria
AM
D001921:Brain / Q000187:drug effects / Q000473:pathology*; D002675:Child, Preschool; D004660:Encephalitis / Q000139:chemically induced / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008691:Methadone / Q000506:poisoning*; D009460:Neurologic Examination; D020258:Neurotoxicity Syndromes / Q000473:pathology*; D012008:Recurrence
D008691:Methadone