Delayed Post-Hypoxic Leukoencephalopathy Induced by an Overdose with Fentanyl Patches: A Case Report
10.3348/jksr.2020.81.4.972
- Author:
Jin Sol CHOI
1
;
Eun Ae YOO
;
Jin Ok CHOI
;
Soo Jung KIM
Author Information
1. Department of Diagnostic Radiology, Presbyterian Medical Center, Jeonju, Korea
- Publication Type:Case Report
- From:Journal of the Korean Radiological Society
2020;81(4):972-978
- CountryRepublic of Korea
-
Abstract:
Fentanyl intoxication has occasionally been reported since fentanyl patches became available for medical use. Delayed post-hypoxic leukoencephalopathy is a complication of hypoxia. However, its neuropsychiatric symptoms can be delayed, and it can progress to leukoencephalopathy even after full recovery from coma due to acute intoxication. Herein, we report a case of fentanyl intoxication in a 65-year-old man who was presented to the hospital because of unconsciousness for 13 hours after using ten fentanyl patches simultaneously. Initial brain CT findings were non-specific. Twenty days later, delayed neuropathologic symptoms manifested, and MRI showed bilaterally symmetrical, heterogeneous, confluent high signal intensities on T2-weighted/fluid attenuated inversion recovery MRI in the cerebral white matter with diffusion restriction. This was followed by rapid exacerbation of neuropathological symptoms with diffuse severe cerebral atrophy over 1 year.
