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A Case of Reversible Neuropsychiatry Symptoms in HIV due to Toxic Leukoencephalopathy

Michelle C Liu1, Amir Garakani, Katherine A Krauskopf

  • 1Ms. Liu is from the Icahn School of Medicine at Mount Sinai, New York, New York; Dr. Garakani is from Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, and Silver Hill Hospital, New Canaan, Connecticut; Dr. Krauskopf is from Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York; and Dr. Robinson-Papp is from Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York.

Innovations in Clinical Neuroscience
|December 6, 2013
PubMed

Insights

Mothball ingestion can cause toxic-leukoencephalopathy, damaging brain white matter. This case highlights a reversible condition in a patient with a history of substance abuse.

Area of Science:

  • Neuroscience
  • Toxicology
  • Neurology

Background:

  • Mothball ingestion is a known cause of toxic-leukoencephalopathy.
  • Paradichlorobenzene, a component of mothballs, is toxic to central nervous system white matter.

Purpose of the Study:

  • To present a case of toxic-leukoencephalopathy secondary to mothball abuse.
  • To discuss the clinical presentation, diagnostic challenges, and reversible nature of this condition.

Main Methods:

  • Case report of a 37-year-old woman with a history of mothball abuse.
  • Clinical assessment including neuropsychiatric evaluation.
  • Magnetic resonance imaging (MRI) for neuroimaging.

Main Results:

  • The patient presented with a neuropsychiatric syndrome including cognitive decline, depression, and psychosis.
  • MRI revealed symmetric leukoencephalopathy and atrophy.
  • Clinical findings were attributed to reversible toxic-leukoencephalopathy from mothball ingestion.

Conclusions:

  • Paradichlorobenzene-induced toxic-leukoencephalopathy can be reversible.
  • In patients with substance abuse history and leukoencephalopathy, toxin-induced causes should be considered.
  • Further investigation into substance abuse is crucial for diagnosis and management.
Keywords:
HANDHIV InfectionMothballsPDBcocaine abuseleukoencephalopathyparadichlorobenzene

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