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The dangers of “Chasing the dragon”: a fatal case of heroin-induced leukoencephalopathy

Iliass Bourekba,I. Halfi,Najwa Ech Cherif Kettani,Meryem Fikri,Mohamed Jidane,F. Touarsa

Published 2023 in BJR|case reports

ABSTRACT

Abstract Heroin-induced leukoencephalopathy (HLE) is a rare toxic encephalopathy associated primarily with heroin inhalation, commonly referred to as “chasing the dragon.” This study presents a clinical case of a 27-year-old polydrug user diagnosed with HLE during hospitalization for rapidly progressive flaccid tetraplegia and aphasia. The clinical manifestations encompassed cerebellar and bulbar dysfunction, coupled with motor impairment and altered consciousness. Based on the clinical data and MRI results, HLE was identified as the most likely cause. This article aims to provide insights into the clinical and radiological aspects of HLE, emphasizing the diagnostic significance of radiological findings. The gold standard examination for diagnosis is MRI, crucial due to the difficulties in obtaining histological confirmation for this rare condition.

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