Devastating Delayed Leukoencephalopathy Associated with Bath Salt Inhalation

C L Kramer¹, D R Wetzel², E F M Wijdicks³

¹Division of Critical Care Neurology, Mayo Clinic Rochester, Rochester, MN, USA. ckramer82@gmail.com.

|December 16, 2015

Abstract

Background:

"Bath salts" or synthetic cathinone toxicity remains a potentially deadly clinical condition. We report a delayed leukoencephalopathy with persistent minimally conscious state.

Methods:

Case report.

Results:

A 36-year-old man presents with delayed encephalopathy, dysautonomia, fulminant hepatic failure, and renal failure from severe rhabdomyolysis after consuming bath salts. MRI showed diffusion restriction in the splenium of the corpus callosum and subcortical white matter.

Conclusions:

The combination of acute leukoencephalopathy, rhabdomyolysis and fulminant hepatic failure may point to bath salt inhalation and should be known to neurointensivists.

Keywords:

3,4-Methylenedioxypyrovalerone (MDPV)Acute liver failure Bath salts Bath salts toxicity Cathinone toxicity Dysautonomia Fulminant hepatic failure Leukoencephalopathy Minimally conscious state Neuroimaging Rhabdomyolysis Splenium of corpus callosum Subcortical white matter

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Devastating Delayed Leukoencephalopathy Associated with Bath Salt Inhalation

Background:

Methods:

Results:

Conclusions:

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