تقرير
Cocaine-Induced Toxic Leukoencephalopathy: A Case Report.
| العنوان: | Cocaine-Induced Toxic Leukoencephalopathy: A Case Report. |
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| المؤلفون: | Eshan SH; Internal Medicine, Ascension Saint Joseph Hospital Chicago, Chicago, USA., Bedross A; Internal Medicine, Ascension Saint Joseph Hospital Chicago, Chicago, USA., Chandra G; Internal Medicine, Ascension Saint Joseph Hospital Chicago, Chicago, USA., Medina Inojosa JR; Preventive Cardiology, Mayo Clinic, Rochester, USA., Chalise S; Internal Medicine, Ascension Saint Joseph Hospital Chicago, Chicago, USA. |
| المصدر: | Cureus [Cureus] 2024 Feb 20; Vol. 16 (2), pp. e54574. Date of Electronic Publication: 2024 Feb 20 (Print Publication: 2024). |
| نوع المنشور: | Case Reports |
| اللغة: | English |
| بيانات الدورية: | Publisher: Cureus, Inc Country of Publication: United States NLM ID: 101596737 Publication Model: eCollection Cited Medium: Print ISSN: 2168-8184 (Print) Linking ISSN: 21688184 NLM ISO Abbreviation: Cureus Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Palo Alto, CA : Cureus, Inc. |
| مستخلص: | We present a case here where a 57-year-old South Asian male with disturbed mental status developed multifocal leukoencephalopathy, which we believe was caused by cocaine usage. Cocaine was detected in the urine toxicological sample. Non-acute CT head, with a follow-up brain MRI demonstrating hyperintensity of the T2 FLAIR signal corresponding to diffusion restriction throughout the whole supratentorial white matter, involving semiovale and subcortical U fibres in the occipital lobes as well as posterior frontal and parietal centrum. It was less likely that the patient had posterior reversible encephalopathy syndrome (PRES), which can potentially manifest similarly in a clinical and imaging context because there was no abrupt rise of blood pressure at presentation or during the patient's stay. Extensive examinations were conducted to exclude additional factors that may contribute to the patient's appearance, including autoimmune, vasculitis, and infectious diseases. Levamisole, a significant chemical that is frequently used to increase the volume of cocaine samples and has been linked to neuronal damage, should be examined in individuals who use cocaine and exhibit these kinds of clinical symptoms. The patient was prescribed 250 mg of methylprednisolone twice daily for five days after it was determined that cocaine-induced neuronal toxicity was the cause of his symptoms. Although no improvement was seen right away, over the course of the next few days, he did exhibit a gradual, albeit slight, improvement in his mental status while residing in the nursing home. It is crucial to comprehend the possible connection between cocaine usage, a commonly abused drug, and people exhibiting similar clinical symptoms. To have a better understanding of the pathophysiology and possible treatment approach, more research is necessary as there is now no recommended therapy regimen. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Eshan et al.) |
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| فهرسة مساهمة: | Keywords: altered mental status; cocaine toxicity; cocaine use; levamisole; substance use disorder (sud); toxic leukoencephalopathy |
| تواريخ الأحداث: | Date Created: 20240325 Latest Revision: 20240326 |
| رمز التحديث: | 20240326 |
| مُعرف محوري في PubMed: | PMC10957391 |
| DOI: | 10.7759/cureus.54574 |
| PMID: | 38524039 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2168-8184 |
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| DOI: | 10.7759/cureus.54574 |