Heroin-induced spongiform leukoencephalopathy (HSLE) is a rare condition that is strongly associated with heroin vapor inhalation which has become a popular method among heroin addicts because it poses a less immediate danger to the user and makes the drug much easier to use. We present a case of a 22-year-old male who presented with dysarthria and cerebellar symptoms starting, after 3 months of heroin inhalation. Diagnosis was confirmed to be HSLE after extensive diagnostic testing. HSLE is a rare complication of which the pathogenesis is poorly understood. Clinical history and characteristic findings on magnetic resonance imaging (diffuse, symmetric T2-hyperintensity, and diffusion restriction in frontal, parietal, occipital lobs, basal ganglia, and superior cerebellum) are diagnostic; however, care should be taken to exclude other etiologies. Treatment is primarily supportive; however, there is anecdotal evidence that coenzyme Q10 may be of benefit. The growing number of victims of the opioid crisis requires that physicians be aware of and counsel patients on the devastating neurological complications that can occur with abuse of these drugs.


中文翻译：

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吸入海洛因滥用引起的中毒性白脑病


海洛因诱发的海绵状白质脑病（HSLE）是与海洛因蒸气吸入密切相关的罕见疾病，已成为海洛因成瘾者的流行方法，因为它对使用者的危害较小，并且使药物更易于使用。我们介绍了一例22岁的男性，在吸入海洛因3个月后开始出现构音障碍和小脑症状。经过广泛的诊断测试，确认为HSLE。HSLE是一种罕见的并发症，对其发病机理了解甚少。具有磁共振成像的临床病史和特征性发现（弥散性，对称的T2高强度和额叶，顶叶，枕叶，基底神经节和小脑上端的弥散受限）具有诊断意义；但是，应注意排除其他病因。治疗主要是支持性的；但是，有轶事证据表明辅酶Q10可能有益。阿片类药物危机的受害者人数越来越多，要求医生意识到并指导患者滥用这些药物可能造成的破坏性神经系统并发症。