1. Intravenous methadone causes acute toxic and delayed inflammatory encephalopathy with persistent neurocognitive impairments.
- Author
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Repple, Jonathan, Haessner, Svea, Johnen, Andreas, Landmeyer, Nils C., Schulte-Mecklenbeck, Andreas, Pawlitzki, Marc, Wiendl, Heinz, and Meyer zu Hörste, Gerd
- Subjects
METHADONE hydrochloride ,KILLER cells ,MAGNETIC resonance imaging ,CENTRAL nervous system ,CEREBROSPINAL fluid - Abstract
Background: The mu-opioid agonist methadone is administered orally and used in opioid detoxification and in the treatment of moderate-to-severe pain. Acute oral methadone–use and –abuse have been associated with inflammatory and toxic central nervous system (CNS) damage in some cases and cognitive deficits can develop in long-term methadone users. In contrast, reports of intravenous methadone adverse effects are rare. Case presentation: Here, we report a patient who developed acute bilateral hearing loss, ataxia and paraparesis subsequently to intravenous methadone-abuse. While the patient gradually recovered from these deficits, widespread magnetic resonance imaging changes progressed and delayed-onset encephalopathy with signs of cortical dysfunction persisted. This was associated with changes in the composition of monocyte and natural killer cell subsets in the cerebrospinal fluid. Conclusion: This case suggests a potential bi-phasic primary toxic and secondary inflammatory CNS damage induced by intravenous methadone. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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