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Severe cerebellitis following methadone poisoning
Fionnghuala Mills1, Suzanna C MacLennan, Catherine J Devile
1Department of Paediatric Neurology, Great Ormond Street Hospital, Great Ormond Street, London, WC1N 1EH, UK. fionnghualamills@doctors.org.uk
Pediatric Radiology
|October 24, 2007
Summary
A child developed cerebellitis after ingesting methadone, showing cerebellar swelling and hydrocephalus. This rare toxic encephalopathy also included watershed injuries, highlighting potential opioid toxicity risks.
Area of Science:
- Neurology
- Toxicology
- Pediatrics
Background:
- Cerebellitis is an inflammation of the cerebellum, often presenting with ataxia and neurological deficits.
- Opioid intoxication can lead to various neurological complications, but cerebellitis following ingestion is rare.
Observation:
- A 3-year-old girl presented with symptoms of cerebellitis after accidental methadone ingestion.
- Computed tomography (CT) revealed diffuse cerebellar swelling and edema, causing fourth ventricle compression and hydrocephalus.
Findings:
- Magnetic resonance imaging (MRI) confirmed the cerebellar changes and identified additional watershed injuries.
- These imaging findings are consistent with a toxic encephalopathy, previously reported mainly with inhaled heroin.
Implications:
- This case highlights that methadone, an opioid, can cause severe toxic encephalopathy with cerebellitis and watershed infarcts.
- The findings underscore the importance of considering opioid toxicity in pediatric cases of unexplained cerebellitis and neurological injury.
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