Reversible delayed leukoencephalopathy after heroin intoxication with hypoxia: a case report.
Delayed neurological deterioration after hypoxia is uncommon. Here we report a case of reversible delayed leukoencephalopathy following intravenous heroin intoxication with hypoxia. A 42-year-old man presented disturbed consciousness and unstable hemodynamic status after intravenous heroin injection. He made a good initial recovery after infection control and hemodynamic support. But his neurological condition deteriorated later on and gradually progressed into akinetic mutism and generalized hypertonia within 3 weeks. Prominent leukoencephalopathy was disclosed by magnetic resonance imaging (MRI) of the brain. His general condition improved again in a few months and follow-up MRI revealed regression of the white matter lesion. Early diagnosis of delayed leukoencephalopathy with appropriate supportive treatment may be worthwhile as illustrated by the reported case.
Chang
Wei-Lun
WL
Division of Neurology, Department of Internal Medicine, Chi Mei Medical Center, Liouying, Taiwan.
Chang
Yu-Kang
YK
Hsu
Sen-Yen
SY
Lin
Gua-Jang
GJ
Chen
Shih-Cheng
SC
D000328:Adult; D001921:Brain / Q000473:pathology; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D000860:Hypoxia / Q000150:complications*; D056784:Leukoencephalopathies / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male