[Clinical and neuroimaging features of heroin spongiform leukoencephalopathy].
OBJECTIVE
To summarize the clinical and radiographic characteristics of heroin spongiform leukoencephalopathy (HSLE).


METHODS
A clinical analysis of 42 cases of HSLE was conducted.


RESULTS
Clinically, the patients with HSLE all had a positive history of inhalation of heated heroin vapor with acute or subacute onset in most cases, presenting initially cerebellar signs. Pyramidal tract lesion was frequently involved, but the sensory system usually remained normal. The consciousness disturbances may occur in the serious cases. Brain CT and magnetic resonance imaging (MRI) revealed extensive symmetric white matter lesions in the cerebrum and cerebellum, and in serious cases, the midbrain and pons could be damaged. Spongiform vacuoles degeneration of white matter characterized the predominant pathological changes.


CONCLUSIONS
Spongiform leukoencephalopathy should be considered in a patient who shows acute cerebellar signs and reports a history of inhaling heated heroin vapor, and a definite diagnosis of HSLE can be made in such a case upon the identification of typical CT or MRI findings.
Zhou
Liang
L
Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. zhouliang_1963 @126.com
Lu
Bing-xun
BX
Yin
Ja
J
D000328:Adult; D001921:Brain / Q000473:pathology*; D005260:Female; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D056784:Leukoencephalopathies / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D055815:Young Adult