PDF(Pubmed)
Abstract：
Cocaine is a widely abused controlled substance. Cocaine use is associated with a myriad of side effects and a sequelae of consequences secondary to its harmful nature and potential adulterants, the most recently described and less known sequelae being leukoencephalopathy. In our case, we describe a 58-year-old male who presented to the ED with agitation and acute stroke-like symptoms with reported rapid onset. Cocaine induced toxic leukoencephalopathy is a diagnosis of exclusion, thus other etiologies of disease were ruled out in a full neurological and infectious workup; most importantly consisting of extensive brain imaging, alluding to the diagnosis of acute cocaine induced toxic leukoencephalopathy in an individual with a confirmed history of cocaine and cannabinoid abuse. Although there is no targeted therapy for the condition to our knowledge, we utilized a supportive approach to treatment in contrast to other reported treatment modalities which included the use of steroids, plasma exchange, and intravenous immunoglobulin. Furthermore, we describe the clinical evaluation and treatment throughout the patient\'s hospital course with his eventual marked improvement from initial presentation.
摘要：
可卡因是一种被广泛滥用的受控物质。可卡因的使用伴随着无数的副作用和后果的后遗症，继发于其有害性质和潜在的掺假，最近描述和鲜为人知的后遗症是白质脑病。在我们的案例中,我们描述了一名58岁的男性,他出现了躁动和急性卒中样症状,并报告起病迅速.可卡因引起的中毒性白质脑病是一种排除性诊断，因此，在完整的神经系统和感染性检查中排除了其他疾病的病因；最重要的是包括广泛的脑成像，暗示有可卡因和大麻素滥用史的人诊断为急性可卡因引起的中毒性白质脑病。尽管据我们所知，这种情况没有针对性的治疗方法，与其他报道的包括使用类固醇的治疗方式相比，我们采用了支持性治疗方法，血浆置换,和静脉注射免疫球蛋白.此外，我们描述了患者在整个住院过程中的临床评估和治疗，并最终从最初的表现显着改善。
