Heroin-induced toxic leukoencephalopathy
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A 64-year-old normotensive female with a history of inhaled heroin use was brought to the emergency department with the chief complaint of altered mental status. Clinical examination was not significant except for confusion. Admitting urine toxicology demonstrated a high level of opioids. After 5 days, the patient developed seizures and was intubated. Clinical neurological examination revealed the weakness of the left upper limb, with a power of 0/5. Initial and repeat CT scan of the brain without contrast and MRI scan of the brain without contrast was obtained during the patient’s hospital stay.

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