Toxic Leukoencephalopathy in a Patient after Intravenous Heroin Injection Following Recovery from Septic Shock: A Case Report and Review of the Literature

一位感染性休克痊癒的病人經靜脈海洛因注射後發生中毒性腦白質病變：個案報告及文獻回顧

李坤鴻(Kun-Hong Li) ； 林益卿(I-Ching Lin) ； 張正辰(Cheng-Chen Chang)

《The Changhua Journal of Medicine》 14卷1期 (2016/03) Pp. 37-43

https://doi.org/10.6501/CJM.1401.006

摘要

中毒性腦白質病變通常涉及連接到更高皮質功能的白質，造成不同神經精神症狀，如注意力不集中、健忘、癡呆、昏迷，甚至死亡。我們提出一位剛經歷呼吸衰竭和感染性休克痊癒的病人，因為靜脈海洛因注射後，引發中毒性腦白質病變。此時磁共振成像(MRI) 對於診斷至關重要，因為臨床病史經常是不可靠，而且臨床表現常是非特異性的。中毒性腦白質病變的治療主要是支持性的。醫生和精神病醫生應該全面瞭解病史並對中毒性腦白質病變的複雜表現保持警覺。

關鍵字

海洛因蒸汽吸入 ； 靜脈海洛因注射 ； 核磁共振攝影 ； 中毒性腦白質病變

並列摘要

Toxic leukoencephalopathy often involves white matter tracts connecting to higher cortical functions that cause different neuropsychiatric symptoms, such as inattention, forgetfulness, dementia, coma or even death. We present a patient who had just recovered after respiratory failure and septic shock, who then developed toxic leukoencephalopathy after intravenous heroin injection. Magnetic resonance imaging (MRI) appears to be essential for making a diagnosis, because clinical history is often unreliable and manifestations are nonspecific. Treatment is mainly supportive for toxic leukoencephalopathy. Physicians and psychiatrists should take a thorough history and be alert to the complex presentations of toxic encephalopathy.

並列關鍵字

heroin vapor inhalation ； intravenous heroin injection ； magnetic resonance imaging ； toxic leukoencephalopathy