Chang Wei-Lun, Chang Yu-Kang, Hsu Sen-Yen, Lin Gua-Jang, Chen Shih-Cheng
Division of Neurology, Department of Internal Medicine, Chi Mei Medical Center, Liouying, Taiwan.
Acta Neurol Taiwan. 2009 Sep;18(3):198-202.
Delayed neurological deterioration after hypoxia is uncommon. Here we report a case of reversible delayed leukoencephalopathy following intravenous heroin intoxication with hypoxia. A 42-year-old man presented disturbed consciousness and unstable hemodynamic status after intravenous heroin injection. He made a good initial recovery after infection control and hemodynamic support. But his neurological condition deteriorated later on and gradually progressed into akinetic mutism and generalized hypertonia within 3 weeks. Prominent leukoencephalopathy was disclosed by magnetic resonance imaging (MRI) of the brain. His general condition improved again in a few months and follow-up MRI revealed regression of the white matter lesion. Early diagnosis of delayed leukoencephalopathy with appropriate supportive treatment may be worthwhile as illustrated by the reported case.
缺氧后迟发性神经功能恶化并不常见。在此，我们报告一例静脉注射海洛因中毒合并缺氧后出现的可逆性迟发性白质脑病病例。一名42岁男性在静脉注射海洛因后出现意识障碍和血流动力学不稳定。在感染控制和血流动力学支持后，他最初恢复良好。但随后他的神经状况恶化，在3周内逐渐发展为运动不能性缄默和全身肌张力增高。脑部磁共振成像（MRI）显示明显的白质脑病。几个月后他的一般状况再次改善，随访MRI显示白质病变消退。如本报告病例所示，早期诊断迟发性白质脑病并给予适当的支持治疗可能是值得的。
