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Neurocritical Care

, Volume 13, Issue 1, pp 93–97 | Cite as

Severe Leukoencephalopathy Following Acute Oxycodone Intoxication

  • Yazmin Morales Odia
  • Madhavi Jinka
  • Wendy C. Ziai
Practical Pearl

Abstract

Background

Post-opioid toxic encephalopathy is described associated with the synthetic opioid, methadone, and after heroin intoxication, (inhaled, injected or ingested).

Methods

We describe the clinical and radiologic findings of a 46-year-old man with oxycodone and oxycontin overdose who developed multifocal encephalopathy and severe cerebellitis causing acute obstructive hydrocephalus, and discuss the possible mechanisms involved.

Results

Brain MRI showed a non-vascular distribution of diffusion positive lesions in both cerebellar hemispheres and globi pallidi with preserved cerebral perfusion, suggesting an inflammatory process. Management required ventilatory support and intraventricular catheter placement.

Conclusions

To our knowledge, this is the first report of this condition associated with oxycodone and oxycontin ingestion. The occurrence of this rare toxic encephalopathy may be related to distribution patterns of opioid receptor subtypes, genetic susceptibility, sensitization, and other specific comorbidities.

Keywords

Opiate Intoxication Encephalopathy MRI 

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Yazmin Morales Odia
    • 1
  • Madhavi Jinka
    • 1
  • Wendy C. Ziai
    • 1
    • 2
    • 3
    • 4
  1. 1.Department of NeurologyThe Johns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of NeurosurgeryThe Johns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Department of Anesthesiology and Critical Care MedicineThe Johns Hopkins University School of MedicineBaltimoreUSA
  4. 4.The Johns Hopkins Hospital, The Johns Hopkins University School of MedicineBaltimoreUSA

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