heroin and Paralysis

To estimate the range and severity of heroin overdose related morbidity.. Cross-sectional survey.. Sydney, Australia.. 198 heroin users.. Sixty-nine per cent had experienced a heroin overdose, 28% in the preceding 12 months. Of those who had overdosed, 79% had experienced at least one overdose-related morbidity symptom. An ambulance had attended overdoses for 59% of subjects, 33% had required hospital treatment for overdose, and 14% had experienced overdose-related complications of sufficient severity to be admitted to a hospital ward. Indirect overdose-related morbidity included: physical injury sustained when falling at overdose (40%), burns (24%) and assault while unconscious (14%). Direct overdose-related morbidity included: peripheral neuropathy (49%), vomiting (33%), temporary paralysis of limbs (26%), chest infections (13%) and seizure (2%).. There appears to be extensive morbidity associated with non-fatal overdose. This is clearly an area that requires more research to document the prevalence and nature of these harms, and factors associated with them.

Topics: Adolescent; Adult; Age of Onset; Cross-Sectional Studies; Drug Overdose; Female; Heroin; Heroin Dependence; Humans; Length of Stay; Male; Middle Aged; Narcotics; New South Wales; Paralysis; Peripheral Nervous System Diseases; Pneumonia; Sex Factors; Time Factors; Vomiting

We report the case of a young man with heroin intoxication. While deeply unconscious, he sustained a compartment syndrome of the arm and shoulder region leading to a lesion of the upper plexus. Immediate surgical decompression by fasciotomy incisions, intensive care treatment including hemofiltration to treat myoglobinemia, intense physical exercise, and mesh-grafting closure of the wounds soon led to unexpected recovery. The function of the arm was restored in such a way that the patient was able to intoxicate himself again. He needed intubation and ventilation but recovered uneventfully.

Topics: Adult; Brachial Plexus; Compartment Syndromes; Drug Overdose; Fasciotomy; Follow-Up Studies; Heroin; Heroin Dependence; Humans; Male; Muscle, Skeletal; Neurologic Examination; Paralysis; Rhabdomyolysis; Substance Abuse, Intravenous

We report a 30-year-old man who developed painful swelling of his right leg and complete sciatic nerve palsy after an i.v. injection of heroin. Excessive elevation of serum creatine phosphokinase indicated the presence of rhabdomyolysis. Fasciotomy of the gluteus maximus led to rapid and complete recovery from sciatic nerve palsy. Nontraumatic rhabdomyolysis may cause a gluteal compartment syndrome that requires immediate fasciotomy.

Topics: Adult; Buttocks; Heroin; Humans; Inflammation; Injections, Intravenous; Leg; Male; Paralysis; Peripheral Nervous System Diseases; Rhabdomyolysis; Sciatic Nerve; Substance-Related Disorders; Syndrome

Heroin addiction is known to cause various medical and neurological complications. We report here a case of rhabdomyolysis following heroin abuse, in which a neurological lesion mimicking transverse myelitis was also noted. A 29-year-old man was found comatose in a kneeling position one day after a heroin overdose. On admission, he was awake, yet with total paralysis of his lower legs. Physical examination revealed marked swelling and tenderness of the four limbs, especially the lower extremities. Deep tendon reflexes and positional sense were absent in both legs; however, pin-prick sense was preserved. Transverse myelitis or spinal cord vasculitis was the initial working diagnosis. Laboratory tests disclosed significantly elevated creatinine kinase of 146289 U/L. Though suffering transient acute renal failure, his neurological abnormalities gradually improved over four weeks and a left foot drop was the only residual lesion at discharge. Rhabdomyolysis, a well defined complication following heroin use, may also cause concomitant neurological symptoms, for which careful differential diagnosis is warranted. With the increasing number of heroin addicts in Taiwan, more cases with rhabdomyolysis-induced neurological symptoms may be observed in the future.

Topics: Adult; Creatine Kinase; Diagnosis, Differential; Heroin; Humans; Male; Myelitis, Transverse; Paralysis; Rhabdomyolysis

A 32-year-old man presented to the accident & emergency (A&E) department complaining of an inability to use his left arm and shoulder. The previous day he had injected heroin intravenously into his left antecubital vein. Examination revealed signs of a left-sided brachial plexus lesion. There was no history or sign of trauma. Neurological investigation revealed motor and sensory loss compatible with a complete brachial plexus lesion. He exhibited a very rare condition, asymmetrical atraumatic brachial plexopathy, thought to result from an inflammatory cause, which not only affects the brachial, but also other plexi or individual nerves in the body and thought to be related to repeated intravenous use of heroin. This is a condition for which there is no specific treatment but which usually resolves spontaneously in the absence of continuing heroin misuse.

Topics: Adult; Arm; Brachial Plexus; Heroin; Humans; Male; Paralysis; Peripheral Nervous System Diseases; Substance Abuse, Intravenous

A case is described of a young man who presented with acute pulmonary edema and flaccid paralysis of the right upper and lower extremity, following his first injection of heroin and was found in a comatose state. Needle electromyographic findings were compatible with a severe lesion of the right brachial plexus and a moderate lesion of the right lumbar plexus. An allergic or a hypersensitivity reaction might have been the possible cause.

Topics: Acute Disease; Adult; Brachial Plexus; Drug Hypersensitivity; Heroin; Humans; Inflammation; Lumbosacral Plexus; Male; Paralysis; Pulmonary Edema

Acute transverse myelitis was observed as a complication of intravenous heroin addiction in a young man. Recovery within seven weeks was good, but not complete. The literature is reviewed and the possible pathogenetic mechanisms are discussed.

Topics: Adult; Heroin; Humans; Male; Myelitis; Paralysis

Reported is a case of Brown-Sequard syndrome following attempted heroin injection into the right external jugular vein. A right-sided hemiparalysis with a contralateral sensory loss of touch, pain, proprioception, and temperature developed over several hours to the C3 dermatome level. A myelogram showed a vasculitis pattern in the lower cervical region. Treatment was with high-dose dexamethasone for ten days. After six weeks of inpatient physical therapy, only minimal motor and sensory return was seen. Although this syndrome is usually due to lateral hemisection of the spinal cord by a stab wound or a gunshot wound, in this case we believe it resulted from chemical transection due to the heroin or quinine diluent or both.

Topics: Adult; Heroin; Humans; Injections, Intravenous; Jugular Veins; Male; Paralysis; Spinal Cord Injuries; Substance-Related Disorders; Syndrome

Topics: Adult; Alcoholic Intoxication; Anuria; Arm; Heroin; Humans; Male; Oliguria; Paralysis; Substance-Related Disorders

Topics: Acute Kidney Injury; Adult; Heroin; Heroin Dependence; Humans; Male; Myoglobinuria; Paralysis

Topics: Adult; Brain; Cocaine; Demyelinating Diseases; Electrocardiography; Heroin; Heroin Dependence; Humans; Infarction; Male; Morphine; Myelitis; Myelitis, Transverse; Myocardial Infarction; Paralysis; Substance-Related Disorders

Topics: Acute Kidney Injury; Adolescent; Adult; Alcoholic Intoxication; Arm Injuries; Brachial Plexus; Coma; Hemoglobins; Heroin; Humans; Leg Injuries; Male; Myoglobin; Paralysis; Peripheral Nerve Injuries; Pressure; Secobarbital; Substance-Related Disorders