Spongiform encephalopathy in addicts inhaling pre-heated heroin

Three subjects, inhaling pre-heated heroin, developed a severe neurological illness. The neuropathological examination at autopsy on two of them demonstrated that it was due to a spongiform encephalopathy. By light and electron microscopy a severe edema with spongiosa and myelin damage were evident. U-fibers, brainstem, spinal cord and peripheral nerves were spared. The origin of the encephalopathy was not identified. The encephalopathy of our cases is similar to that described by Wolters et al. in 1982 in Holland.