title: Acute myelopathy selectively involving lumbar anterior horns following intranasal insufflation of ecstasy and heroin.
abstract: We report a patient who developed acute myelopathy after intranasal insufflation of amphetamines and heroin. The functional prognosis was very poor; after 4 months, she remained paraplegic. MRI imaging showed selective T2 hyperintensity and intense enhancement confined to the spinal anterior horns and lumbar nerve roots and plexus. This unique MRI pattern, together with neurophysiological data, suggests that the pathological process at the first primary affected spinal anterior horns (SAH), conditioning motoneuron cell death, and then nerve roots and lumbar plexus as a consequence of wallerian degeneration.
authors.affiliation: San Raffaele Scientific Institute, Department of Neuroradiology, Via Olgettina 60, Milan, 20132, Italy.
authors.forename: Nilo
authors.initials: N
authors.lastname: Riva
authors.forename: Nilo
authors.initials: N
authors.lastname: Riva
authors.forename: Paolo
authors.initials: P
authors.lastname: Morana
authors.forename: Federica
authors.initials: F
authors.lastname: Cerri
authors.forename: Simonetta
authors.initials: S
authors.lastname: Gerevini
authors.forename: Stefano
authors.initials: S
authors.lastname: Amadio
authors.forename: Fabio
authors.initials: F
authors.lastname: Formaglio
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Comi
authors.forename: Mauro
authors.initials: M
authors.lastname: Comola
authors.forename: Ubaldo
authors.initials: U
authors.lastname: Del Carro