Make the Dx: Solution to 'Is it the drugs?'
Key Takeaways
Can you make the diagnosis? Click here to review the case and check your answer below.
Unless you’re a neurologist or addiction psychiatrist, the diagnosis here may be foreign.
Following a battery of diagnostic studies, including brain biopsy, and in light of her extensive opioid history, a diagnosis of toxic leukoencephalopathy (TLE) was made.
Substances that can cause TLE include benzodiazepines, oxycodone, methadone, and methotrexate.
The mechanism of TLE remains to be elucidated, and it is difficult to predict who will develop this condition, with few cases having been reported. Treatment of TLE is supportive and involves eliminating any further exposure to toxins.
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