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Published on: October 27, 2021
Severe dopaminergic pathways damage in a case of chronic toluene abuse
Sokratis G Papageorgiou1, Evgenia Karantoni, Dionysios Pandis
1Department of Neurology, Eginition Hospital, Medical School, Athens National University, Athens, Greece. sokpapa@med.uoa.gr
Introduction:
Toluene toxicity primarily affects central nervous system white matter, causing a characteristic brain MRI pattern.
Case Report:
A toluene addicted man, after an abstinence period and a treatment with neuroleptics, presented with severe worsening of preexisting generalized tremor, opsoclonus, dysarthria, gait inability, jerky tendon reflexes and behaviour disorders. Magnetic resonance imaging showed mild leukoencephalopathy and hypointensities in deep gray matter nuclei. The DaT-scan revealed a decrease in presynaptic dopamine reuptake.
Conclusion:
Clinical and neuroradiological findings and the possible sensitivity to neuroleptics indicate dopaminergic impairment. Our case suggests that chronic toluene abuse causes presynaptic dopaminergic depletion.
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