Acute progressive paraplegia in heroin-associated myelopathy
Publication date: Available online 23 February 2018 Source:Journal of Clinical Neuroscience Author(s): Kyle W. Mahoney, Meghan Romba, Philippe Gailloud, Izlem Izbudak, Deanna Saylor As the opioid epidemic continues, understanding manifestations of abuse, including heroin-associated myelopathy remains essential. Here we describe a young man with a past medical history significant for polysubstance abuse who developed acute-onset, rapidly progressive myelopathy after resumption of intravenous heroin use. He had significant spinal cord involvement with findings suggestive of heroin-associated myelopathy. The salient features of this case include diffusion imaging of the spine and spinal angiography supporting a possible vasculopathy as the pathophysiologic mechanism underlying heroin-associated myelopathy. Additionally, CSF studies showed the transition from a neutrophilic pleocytosis to a lymphocytic pleocytosis suggesting an inflammatory component.
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research