NISPA

Nijmegen Institute for Scientist-Practitioners in Addiction

Toxic Leukoencephalopathy Presenting as Lethal Catatonia

TitelToxic Leukoencephalopathy Presenting as Lethal Catatonia
PublicatietypeJournal Article
Jaar van publicatie2019
Auteursvan Esch AMJ, Fest A, Hoffland BS, Janzing JGE, Steens SCA, Esselink RAJ, Schellekens AFA
UitgaveJ Addict Med
Volume13
Nummer3
Pagina's241-244
Publicatiedatum2019 May/Jun
ISSN1935-3227
Samenvatting

INTRODUCTION: Catatonia is a syndrome that can present in different forms and can occur in multiple psychiatric and somatic conditions. This case report describes lethal catatonia caused by delayed toxic leukoencephalopathy after excessive use of cocaine and methadone. The characteristic radiographic imaging and biphasic course are discussed.

CASE REPORT: A 54-year-old woman was presented unconsciously at the emergency department after intoxication with methadone and cocaine. After initial recovery, her condition deteriorated unexpectedly, resulting in lethal catatonia. Magnetic resonance imaging (MRI) showed hyperintense white matter abnormalities and diffusion restriction, evident for leukoencephalopathy.

DISCUSSION: Catatonia can develop in multiple psychiatric and somatic diseases, including toxic leukoencephalopathy. A biphasic course and specific MRI findings are characteristics for delayed toxic leukoencephalopathy, due to intoxication with drugs.

DOI10.1097/ADM.0000000000000470
Alternatieve uitgaveJ Addict Med
PubMed ID30394993