Methadone-induced toxic leukoencephalopathy: diagnosis and follow-up by magnetic resonance imaging including diffusion-weighted imaging and apparent diffusion coefficient maps.

BACKGROUND AND
PURPOSE: Effects of methadone misuse have been rarely described. The purpose of this case report is to increase the knowledge of methadone-related leukoencephalopathy.
METHODS: We report the long-term follow-up by brain magnetic resonance imaging including isotropic diffusion-weighted imaging and mean apparent diffusion coefficient values of a 49-year-old patient who attempted suicide by intravenous methadone. RESULTS AND
CONCLUSIONS: Lesion pattern included subtle cerebellar involvement, mainly reversible extensive bilateral and symmetric brain involvement, cystic degeneration in the periventricular regions, sparing of corpus callosum and subcortical U-fibers, development of diffuse brain atrophy, and clear-cut clinical improvement.