rss
BMJ Case Reports 2009; doi:10.1136/bcr.08.2008.0669
  • Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Acute myelopathy selectively involving lumbar anterior horns following intranasal insufflation of ecstasy and heroin

  1. Nilo Riva1,
  2. Nilo Riva1,
  3. Paolo Morana2,
  4. Federica Cerri2,
  5. Simonetta Gerevini1,
  6. Stefano Amadio2,
  7. Fabio Formaglio2,
  8. Giancarlo Comi2,
  9. Mauro Comola2,
  10. Ubaldo Del Carro2
  1. 1
    San Raffaele Scientific Institute, Department of Neuroradiology, Via Olgettina 60, Milan, 20132, Italy
  2. 2
    San Raffaele Scientific Institute, Department of Neurology, Neuro-rehabilitation and Clinical Neurophysiology, via Olgettina 48, Milan, 20132, Italy
  1. riva.nilo{at}hsr.it
  • Published 23 January 2009

Summary

We report a patient who developed acute myelopathy after intranasal insufflation of amphetamines and heroin. The functional prognosis was very poor; after 4 months, she remained paraplegic. MRI imaging showed selective T2 hyperintensity and intense enhancement confined to the spinal anterior horns and lumbar nerve roots and plexus. This unique MRI pattern, together with neurophysiological data, suggests that the pathological process at the first primary affected spinal anterior horns (SAH), conditioning motoneuron cell death, and then nerve roots and lumbar plexus as a consequence of wallerian degeneration

Footnotes

  • Competing interests: None.

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article