Open AccessAcute myelopathy selectively involving lumbar anterior horns following intranasal insufflation of ecstasy and heroin
Author(s) -
Nilo Riva,
Paolo Morana,
Federica Cerri,
Simonetta Gerevini,
Stefano Amadio,
Fabio Formaglio,
Gıancarlo Comı,
Mauro Comola,
Ubaldo Del Carro
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.08.2008.0669
Subject(s) - medicine , anesthesia , lumbar plexus , lumbar , spinal cord , surgery , psychiatry
We report a patient who developed acute myelopathy after intranasal insufflation of amphetamines and heroin. The functional prognosis was very poor; after 4 months, she remained paraplegic. MRI imaging showed selective T2 hyperintensity and intense enhancement confined to the spinal anterior horns and lumbar nerve roots and plexus. This unique MRI pattern, together with neurophysiological data, suggests that the pathological process at the first primary affected spinal anterior horns (SAH), conditioning motoneuron cell death, and then nerve roots and lumbar plexus as a consequence of wallerian degeneration.