heroin and Muscular-Diseases

The spectrum of neurological complications associated with heroin addiction has changed in the past six years because of the progressive knowledge of the neurological complications related to HIV infection. We reviewed 48 heroin addicts with neurological complications and 452 heroin overdose who were seen in the Emergency Unit of our hospital during 1988 and the publications since 1967. Regarding the overdose we present the results of a prospective study leading to determine the causes. We emphasize the relationship with the level of total morphine in serum, instead of conjugate morphine, and with the presence of high levels of benzodiazepines found in the plasma rather than an hypothetic hypersensitivity phenomenon. We resume the neurological complications related with heroin addiction: spongiform leukoencephalopathy, epileptic seizures, stroke, transverse myelopathy and neuromuscular complications such mononeuropathy, plexopathy, acute inflammatory demyelinating polyradiculoneuropathy, rhabdomyolysis, fibrosing myopathy, musculoskeletal syndrome and acute bacterial myopathy. Some of such complications (i.e. transverse myelitis, polyradiculoneuropathy, leucoencephalopathy) must rise the suspicion of an HIV infection. Likewise, in patients assisted for overdosage we believe it's necessary rule out myoglobinuria by means of CPK serum levels and detection of urine hematic pigments without red blood cels in the urine sediment, in order to prevent and treat the renal failure. We report the results of muscular biopsy found in the musculoskeletal syndrome, which are similar to those found in alcoholic myopathy. Finally, we describe the clinical and diagnostic aspects in an unusually neuromuscular complication: the acute bacterial myopathy.

Topics: Cerebrovascular Disorders; Coma; Drug Overdose; Epilepsy; Heroin; Heroin Dependence; Humans; Leukoencephalopathy, Progressive Multifocal; Muscular Diseases; Myelitis, Transverse; Nervous System Diseases; Peripheral Nervous System Diseases

Topics: Abscess; Adult; Animals; Autopsy; Blindness; Brain Diseases; Cerebrovascular Disorders; Endocarditis; Haplorhini; Hepatitis A; Heroin; Heroin Dependence; Humans; Male; Muscular Diseases; Myelitis, Transverse; Nervous System Diseases; New York City; Peripheral Nervous System Diseases; Quinine; Substance-Related Disorders; Tetanus

To investigate the possible causes of unexplained hemorrhage into the neck musculature in deaths due to drowning, all cases of drowning between the years 1985 and 1995 examined by members of the Department of Forensic Pathology, University of Sheffield were reviewed. Cases were selected in which hemorrhage was found within the neck musculature but in which no apparent explanation for the hemorrhage, such as compression of the neck or trauma, was present. Eight cases were identified from a total of 99 deaths from drowning. Postmortem hypostasis was distributed in the back or diffusely in 6 cases and in the face in 3 cases. The degree of decomposition varied but was severe in only 1 case. A raised blood alcohol level was detected in 3 cases. Anterior neck compartment hemorrhage is probably due to hypostasis in a high proportion of cases. The Prinsloo and Gordon artifact may be an operative factor in at least some cases. Hemorrhage may result from violent neck movements during the process of drowning. Apparent "bruising" of the neck musculature does not always indicate compression of or trauma to the neck.

Topics: Adult; Aged; Aged, 80 and over; Depressive Disorder; Drowning; Ethanol; Hemorrhage; Heroin; Humans; Middle Aged; Muscular Diseases; Neck Muscles; Prevalence

Topics: Adult; Analgesics; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antioxidants; Arm; Combined Modality Therapy; Drug Overdose; Edema; Heroin; Heroin Dependence; Humans; Male; Methylprednisolone; Muscular Diseases; Oxygen Inhalation Therapy; Pain; Rhabdomyolysis; Syndrome

Topics: Adult; Heroin; HIV Infections; HIV-1; HTLV-II Infections; Humans; Male; Muscular Diseases; Substance Abuse, Intravenous

A patient developed focal fibrotic myopathy after many years of intramuscular heroin use. While such changes have been associated with chronic intramuscular injections of pentazocine and meperidine, a similar myopathy resulting from chronic intramuscular heroin has not been convincingly described.

Topics: Heroin; Humans; Injections, Intramuscular; Male; Middle Aged; Muscular Diseases

Topics: Female; Glutamate-Ammonia Ligase; Heroin; Humans; Levodopa; Male; Muscular Diseases; Succinylcholine; Triamcinolone

Topics: Adult; Heroin; Humans; Hypercalcemia; Kidney Papillary Necrosis; Male; Muscular Diseases; Myoglobinuria; Renal Dialysis; Substance-Related Disorders

Topics: Acute Kidney Injury; Adult; Heroin; Humans; Male; Muscular Diseases; Renal Dialysis

Topics: Acute Disease; Adult; Heroin; Humans; Male; Muscular Diseases

Topics: Ataxia; Coma; Depression; Electroencephalography; Female; Heroin; Heroin Dependence; Humans; Male; Mental Disorders; Muscular Diseases; Myelitis, Transverse; Nervous System Diseases; Neuritis; Neurocognitive Disorders; Nystagmus, Pathologic; Parkinson Disease, Secondary; Sexual Dysfunction, Physiological; Sleep Wake Disorders; Substance Withdrawal Syndrome; Tremor

During a recent 5-month period, 16 intravenous heroin users were hospitalized with a previously unrecognized complication of drug abuse. The characteristic symptoms were similar in all patients and included fever, paraspinal myalgias, and periarthritis. There was no evidence of bacterial infection, hepatitis, or drug abstinence as the cause of these musculoskeletal symptoms. Continued heroin use was associated with progressive musculoskeletal symptoms, while discontinuation of heroin use resulted in complete recovery. Antibiotics did not affect the outcome, and the syndrome was self-limited in all hospitalized patients. The pathogenesis of this syndrome is unknown but may be related to the heroin, which was described as brown by the patients, or an adulterant.

Topics: Adult; Anti-Bacterial Agents; Heroin; Heroin Dependence; Humans; Length of Stay; Male; Muscular Diseases; Pain; Periarthritis; Spasm; Spondylitis

In two cases of Guillain-Barré syndrome (acute polyneuritis) as a complication of narcotic abuse, the onset of paralysis began approximately 4 and 12 hours after self-administration of opiates intravenously. Bulbar and respiratory paralysis developed in one patient and required prolonged ventilation therapy; the other patient had peripheral muscular and unilateral facial weakness, with notable pleocytosis was present in both.

Topics: Adolescent; Adult; Agglutinins; Cerebrospinal Fluid; Heroin; Heroin Dependence; Humans; Injections, Intravenous; Lymphocytes; Male; Muscular Diseases; Polyradiculopathy; Respiration, Artificial; Respiratory Paralysis; Respiratory Tract Diseases

Topics: Acute Kidney Injury; Adult; Coma; Contracture; Female; Heroin; Humans; Ischemia; Male; Muscles; Muscular Diseases; Pressure; Pressure Ulcer; Secobarbital; Skin Diseases; Substance-Related Disorders

Topics: Acute Kidney Injury; Adult; Biopsy, Needle; Heroin; Heroin Dependence; Humans; Male; Muscles; Muscular Diseases; Myoglobinuria; Substance-Related Disorders

Topics: Adult; Black People; Brachial Plexus; Electrodiagnosis; Electromyography; Evoked Potentials; Female; Heroin; Heroin Dependence; Humans; Injections, Intravenous; Injections, Subcutaneous; Lumbosacral Plexus; Male; Motor Neurons; Muscular Diseases; Neural Conduction; Neuritis; New York City; Substance-Related Disorders; Time Factors

Topics: Acute Kidney Injury; Adult; Biopsy; Electromyography; Heroin; Humans; Leg; Male; Morphine Dependence; Muscles; Muscular Diseases; Myoglobinuria; Pulmonary Edema

Topics: Acute Kidney Injury; Adult; Aspartate Aminotransferases; Barbiturates; Chlorpromazine; Coma; Drug-Related Side Effects and Adverse Reactions; Female; Glutethimide; Heroin; Humans; Kidney Function Tests; L-Lactate Dehydrogenase; Male; Methadone; Methamphetamine; Muscular Diseases; Myoglobinuria; Phosphocreatine; Pyruvate Kinase; Quinine; Substance-Related Disorders

Topics: Acute Disease; Acute Kidney Injury; Adult; Autopsy; Cell Membrane Permeability; Drug Contamination; Electromyography; Heroin; Humans; Injections, Intravenous; Injections, Subcutaneous; Male; Muscle Contraction; Muscular Diseases; Myoglobin; Myoglobinuria; Rest; Substance-Related Disorders; Time Factors

Topics: Heroin; Humans; Muscular Diseases; Substance-Related Disorders