Case reportLeucoencephalopathy following abuse of sniffed heroin
Introduction
Heroin-induced leucoencephalopathy is a rare condition despite numerous heroin consumers. We report the case of a patient having delayed severe encephalopathy after heroin sniffed abuse with favourable outcome and discuss the specificity of brain MRI images.
Section snippets
Case report
A 29-year-old man was admitted for acute cognitive impairment. His medical history was: active tobacco smoking, cannabis, alcohol and heroin abuse for many years, depression and several suicide attempts. Three weeks earlier, he had been admitted for coma due to sniffed heroin abuse responsive to naloxone infusion. He had presented no hypoxia and endotracheal intubation had not been necessary. Pneumopathy consecutive to the coma had been diagnosed and amoxicilline/clavulanic acid (3 g per day for
Discussion
Heroin-induced leucoencephalopathy is an infrequently encountered toxic leucoencephalopathy which was first reported by Wolters et al. in 1982 [2]. Classic presentation of heroin-induced leucoencephalopathy occurring in patient inhaling heroin, also known as “chasing the dragon”, includes severe motor and cerebellar involvement, poor prognosis and symmetric typical infratentorial radiological findings. Indeed, involvement of the cerebellar and posterior cerebral white matter including the
Authors contributions
Romain Lefaucheur: acquisition of data, analysis and interpretation, critical revision of the manuscript for important intellectual content.
Axel Lebas: acquisition of data, analysis and interpretation, critical revision of the manuscript for important intellectual content.
Emmanuel Gérardin: acquisition of data, analysis and interpretation.
Lou Grangeon: acquisition of data, analysis and interpretation.
Ozlem Ozkul-Wermester: acquisition of data, analysis and interpretation.
Carole Aubier-Girard:
Acknowledgment
We thank Dr A. Lebas for his help to create brain MRI figure with his software JimboDicomviewer.
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