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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.

Neurocritical Care
|December 16, 2015
PubMed
Summary
This summary is machine-generated.

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Synthetic cathinone (bath salt) toxicity can cause delayed leukoencephalopathy. This case report details a patient who developed a persistent minimally conscious state after bath salt use.

Area of Science:

  • Neurology
  • Toxicology
  • Emergency Medicine

Background:

  • Synthetic cathinone (
  • bath salts
  • ) abuse presents a significant and potentially fatal clinical challenge.
  • Delayed neurological complications following intoxication are increasingly recognized.

Observation:

  • A 36-year-old male experienced delayed encephalopathy, dysautonomia, and multi-organ failure (hepatic and renal) after consuming bath salts.
  • Severe rhabdomyolysis was a prominent feature of his presentation.
  • Magnetic resonance imaging (MRI) revealed restricted diffusion in the corpus callosum's splenium and subcortical white matter.

Findings:

  • The patient developed a persistent minimally conscious state secondary to the synthetic cathinone toxicity.
Keywords:
3,4-Methylenedioxypyrovalerone (MDPV)Acute liver failureBath saltsBath salts toxicityCathinone toxicityDysautonomiaFulminant hepatic failureLeukoencephalopathyMinimally conscious stateNeuroimagingRhabdomyolysisSplenium of corpus callosumSubcortical white matter

Related Experiment Videos

  • The MRI findings indicated acute leukoencephalopathy affecting specific white matter regions.
  • The clinical course was complicated by fulminant hepatic failure and renal failure.
  • Implications:

    • This case highlights the potential for severe, delayed neurological damage from bath salt ingestion.
    • The constellation of acute leukoencephalopathy, rhabdomyolysis, and hepatic failure may serve as a diagnostic indicator for synthetic cathinone toxicity.
    • Neurointensivists and emergency physicians should be aware of these severe manifestations for timely diagnosis and management.