Transverse Myelitis and Heroin Abuse: A Case Report

The usage of heroin is associated with a variety of neurologic disorders,including acute transverse myelitis. In this study we present a 19 year old man who was suffered   from insufflated heroin after several months of abstinence, and admitted to hospital   emergency department, unconscious. He res...

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Main Authors: Mohammad Rohani, Fowzieh Ben Isa, Farzad Sina, Bahram Haghi-Ashtiani
Format: Article
Language:English
Published: Iran University of Medical Sciences 2010-02-01
Series:Medical Journal of The Islamic Republic of Iran
Subjects:
Online Access:http://mjiri.tums.ac.ir/browse.php?a_code=A-10-1-91&slc_lang=en&sid=1
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author Mohammad Rohani
Fowzieh Ben Isa
Farzad Sina
Bahram Haghi-Ashtiani
author_facet Mohammad Rohani
Fowzieh Ben Isa
Farzad Sina
Bahram Haghi-Ashtiani
author_sort Mohammad Rohani
collection DOAJ
description The usage of heroin is associated with a variety of neurologic disorders,including acute transverse myelitis. In this study we present a 19 year old man who was suffered   from insufflated heroin after several months of abstinence, and admitted to hospital   emergency department, unconscious. He responded to fluid therapy and Naloxone,but could not move his legs on examination. He had flaccid paralysis of both   legs, acute urinary retention and diminished rectal tone. Deep tendon reflexes were   absent with downward plantar reflexes. Analysis of CSF was normal, and the MRI of   the spine revealed confluent hyperintensity on T2-weighted images from the C5 to   T2 vertebral levels involving the majority of the cord substance. The cord was mildly   expanded without any enhancement after Gadolinium injection. Suggested mechanisms   of heroin-associated myelopathy include hypotension, a direct toxic effect of heroin, vasculitis, and hypersensitivity reaction. Hypersensitivity was the predominant theory since the initial reports, implied that most patients with developed myelopathy had relapsed into heroin use after a period of abstinence.Treatment with either IV corticosteroids or immunopheresis could blunt the immune response, preventing disability. Efficacy of these methods require more studies in future.
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spelling doaj.art-38dff2e7a2ed4c6282274878d2b282f22022-12-22T01:08:35ZengIran University of Medical SciencesMedical Journal of The Islamic Republic of Iran1016-14302251-68402010-02-01234238240Transverse Myelitis and Heroin Abuse: A Case ReportMohammad RohaniFowzieh Ben IsaFarzad SinaBahram Haghi-AshtianiThe usage of heroin is associated with a variety of neurologic disorders,including acute transverse myelitis. In this study we present a 19 year old man who was suffered   from insufflated heroin after several months of abstinence, and admitted to hospital   emergency department, unconscious. He responded to fluid therapy and Naloxone,but could not move his legs on examination. He had flaccid paralysis of both   legs, acute urinary retention and diminished rectal tone. Deep tendon reflexes were   absent with downward plantar reflexes. Analysis of CSF was normal, and the MRI of   the spine revealed confluent hyperintensity on T2-weighted images from the C5 to   T2 vertebral levels involving the majority of the cord substance. The cord was mildly   expanded without any enhancement after Gadolinium injection. Suggested mechanisms   of heroin-associated myelopathy include hypotension, a direct toxic effect of heroin, vasculitis, and hypersensitivity reaction. Hypersensitivity was the predominant theory since the initial reports, implied that most patients with developed myelopathy had relapsed into heroin use after a period of abstinence.Treatment with either IV corticosteroids or immunopheresis could blunt the immune response, preventing disability. Efficacy of these methods require more studies in future.http://mjiri.tums.ac.ir/browse.php?a_code=A-10-1-91&slc_lang=en&sid=1Transverse MyelitisDrug abuseHeroin
spellingShingle Mohammad Rohani
Fowzieh Ben Isa
Farzad Sina
Bahram Haghi-Ashtiani
Transverse Myelitis and Heroin Abuse: A Case Report
Medical Journal of The Islamic Republic of Iran
Transverse Myelitis
Drug abuse
Heroin
title Transverse Myelitis and Heroin Abuse: A Case Report
title_full Transverse Myelitis and Heroin Abuse: A Case Report
title_fullStr Transverse Myelitis and Heroin Abuse: A Case Report
title_full_unstemmed Transverse Myelitis and Heroin Abuse: A Case Report
title_short Transverse Myelitis and Heroin Abuse: A Case Report
title_sort transverse myelitis and heroin abuse a case report
topic Transverse Myelitis
Drug abuse
Heroin
url http://mjiri.tums.ac.ir/browse.php?a_code=A-10-1-91&slc_lang=en&sid=1
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AT fowziehbenisa transversemyelitisandheroinabuseacasereport
AT farzadsina transversemyelitisandheroinabuseacasereport
AT bahramhaghiashtiani transversemyelitisandheroinabuseacasereport