A young woman with dysarthria, bradykinesia and ataxia

Angelos Charokopakis, Despina Kriketou, Demetrios Exarhos


A 23-year old female presented in the Emergency Department with dysarthria, bradykinesia and ataxia. The patient inhaled heroin one week before the onset of the symptoms. She was tachypnoeic but haemodynamically stable (blood pressure 145/90 mm Hg) with a normal sinus rhythm. Corneal reflexes were present bilaterally and the motor examination revealed axial myoclonus. General examination revealed no cardiac murmurs whilst the chest and abdomen were unremarkable. No needle marks were observed on the skin. After a normal initial brain computed tomography (CT) scan, the patient was further evaluated with brain magnetic resonance imaging (MRI) A second MRI was performed after a 13 day hospitalisation.


Chasing the dragon; Heroin toxicity; Toxic leukoencephalopathy; MRI

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DOI: http://dx.doi.org/10.36162/hjr.v3i1.231


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