Submission Type

Case Report


Introduction: Toxic leukoencephalopathy (TLE) is characterized by damage to myelin of cerebral white matter and is caused by a number of offending agents, including drugs of abuse. The clinical presentation of TLE is variable and not fully understood.

Clinical Findings: A 51-year-old male presented with pneumonia, parapneumonic effusion, and acute kidney injury. His medical course was complicated by neurobehavioral changes, including aggression and social withdrawal.

Diagnoses, interventions, and outcomes: The patient was diagnosed with acute toxic leukoencephalopathy based on diffuse subcortical T2-weighted-fluid-attenuated inversion recovery (T2/FLAIR) on brain MRI, bilateral frontal arrhythmic delta waves on encephalogram, and a history of polysubstance abuse.

Conclusions: This case suggests that TLE should be included in the differential diagnosis for patients with a history of substance use and neurobehavioral changes, including agitation and social withdrawal. It also emphasizes the need to identify and treat patients with substance use disorder to prevent common or rare complications.

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Neurology Commons



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