Reversible delayed leukoencephalopathy after heroin intoxication with hypoxia: a case report

Area of Science:

• Neurology
• Toxicology

Background:

• Delayed neurological deterioration following hypoxia is a rare clinical presentation.
• Intravenous heroin intoxication can lead to various neurological complications.

Observation:

• A 42-year-old male presented with altered consciousness and hemodynamic instability after intravenous heroin use.
• Initial recovery was followed by a significant neurological decline over three weeks, progressing to akinetic mutism and hypertonia.

Findings:

• Magnetic resonance imaging (MRI) revealed significant leukoencephalopathy.
• The patient experienced a gradual recovery over several months, with follow-up MRI demonstrating regression of white matter lesions.

Implications:

• This case underscores the possibility of reversible delayed leukoencephalopathy after heroin intoxication and hypoxia.
• Early diagnosis and supportive management are crucial for improving outcomes in such rare neurological events.