Heroin Relapse "Strikes a Nerve": A Rare Case of Drug-Induced Acute Myelopathy.
heroin abuse
heroin-induced myelopathy
intravenous drug use
myelopathy
opioid epidemic
opioid-induced myelopathy
opioids
transverse myelitis
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
accepted:
23
06
2021
entrez:
30
7
2021
pubmed:
31
7
2021
medline:
31
7
2021
Statut:
epublish
Résumé
Opioid addiction is a major public health problem. Through a commitment to individualized treatment plans meant to help patients meet personal goals, behavioral therapy can encourage abstinence and help prevent relapses that can have debilitating consequences. This case describes a 31-year-old male with heroin relapse who presented with flaccid quadriparesis as well as loss of sensation below the T2-3 spinal level, loss of rectal tone, and urinary retention. A urine drug screen (UDS) was positive for opiates and amphetamines. Autoimmune serologies were negative. Cerebrospinal fluid (CSF) analysis was negative for any acute ongoing infectious process. Magnetic resonance imaging (MRIs) of the cervical and thoracic spine showed increased intramedullary signals with spinal cord expansion from C2-T2, indicating acute transverse myelitis. Upon completion of the aforementioned work-up, idiopathic transverse myelopathy (TM) was diagnosed, and the patient was started on intravenous (IV) methylprednisolone; he also received five sessions of plasmapheresis. By process of elimination, suspicion remained of a diagnosis of opioid-induced myelopathy. The patient showed mild improvement in his original sensory deficits and flaccid quadriplegia.
Identifiants
pubmed: 34327090
doi: 10.7759/cureus.15865
pmc: PMC8301723
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e15865Informations de copyright
Copyright © 2021, Sidhu et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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