Citation

Meyer MA. Neurol. Int. 2013; 5(3): 41-44.

Copyright

(Copyright © 2013, MDPI: Multidisciplinary Digital Publications Institute)

DOI

10.4081/ni.2013.e13

PMID

unavailable

Abstract

Delayed post-hypoxic leukoencephalopathy is a rare clinical phenomenon usually observed in a small number of carbon monoxide poisoning survivors. A similar phenomenon is reported here in a patient who successfully recovered from a large overdose of diazepam and methadone, but then abruptly declined 3 weeks after the initial event. Magnetic resnance revealed confluent white matter hyperintensity on fluid-attenuated inversion recovery and T2 weighted sequences, and spectroscopy revealed elevated peaks in choline, creatinine, and lactate. Analysis and review of the literature suggests this phenomenon occurs on average about 19 days after the initial event. Although the pathophysiology remains obscure, it is noted here that the mean lucid interval coincides approximately with the replacement half-life for myelin related lipids and proteins. © M.A. Meyer, 2013.

Language: en

Keywords

adult; human; naloxone; female; case report; depression; white matter; chronic pain; suicide attempt; disease severity; MRI; drug overdose; review; behavior disorder; drug intoxication; pathophysiology; diazepam; backache; benzodiazepine; methadone; disease exacerbation; computer assisted tomography; flumazenil; neurologic disease; antibiotic agent; positron emission tomography; nuclear magnetic resonance spectroscopy; aspiration pneumonia; psychosocial withdrawal; leukocytosis; lethargy; memory disorder; disease activity; hyperkalemia; fluorodeoxyglucose f 18; breathing disorder; gray matter; diffusion weighted imaging; personal hygiene; leukoencephalopathy; Leukoencephalopathy; delayed post hypoxic leukoencephalopathy; Myelin; White matter