Question - What are the clinical characteristics of the leukoencephalopathy that may develop as a result of the inhalation of heroin pyrolysate (“chasing the dragon”)?
Answer- The cited article reports “Clinically, the condition has three stages, progressing from cerebellar signs and motor restlessness to pyramidal and pseudobulbar signs and, in a minority of patients, to a terminal stage characterized by spasms, hypotonic paresis and ultimately death. Symmetric spongioform degeneration occurs, particularly in the cerebral and cerebellar white matter and in corticospinal and solitary tracts.” (Keogh CF et al. Neuroimaging features if heroin inhalation toxicity: “Chasing the dragon”. 2003 Am J Roentgen 180:847-850)