Table 4 Summary of published case reports of AOE
From: Methadone-induced encephalopathy: a case series and literature review
Author(s) | Age/sex | Clinical presentation | Clinical findings in discharge | Lab Data | Time to imaging | MRI findings |
|---|---|---|---|---|---|---|
Anselmo M. Et al (2005) [10] | 3yo, M | LOC, irregular breathing, low BP | Mild Ataxia | Urine toxicology: positive for methadone after 36 h | Day 6 | High T2 in cerebellar hemispheres and hippocampus |
Mills F. Et al (2008) [11] | 3yo, F | LOC, hard breathing, hypothermia | Spastic dysplasia and dystonia | Urine toxicology: positive for methadone | Day 2 | FLAIR: damage to gray matter and white matter of cerebellum with marked swelling |
Riascos R (2008) [12] | 22mo,- | LOC | Brain death | Urine toxicology: positive for methadone, acetaminophen and salicylate | In admission day | Diffuse bilateral cerebellar infarction, absence of central intra cranial blood flow, supra and infra tentorial gray matter thickening |
Corré J. Et al (2013) [13] | 29yo, M | LOC, hypothermia, bradypnea | Good recovery, except persistent renal failure and kinetic cerebellar syndrome | Blood analysis was positive for alcohol, cannabis, methadone (146 ng/ml), and benzodiazepines | At first day of admission. | FLAIR and DWI: high in both cerebellar and basal ganglia (globus pallidus) |
Metkees M. Et al (2015) [14] | 15yo, F | LOC, hypothermia, hypercapnia, HTN | Death | Detailed history revealed methadone ingestion of unknown quantity | Not mentioned | T2 and DWI: high in white matter of both hemisphere (sparing sub cortical U-fibers and deep gray matter, cortical or cerebellar) |
Cerase A. Et al (2011) [4] | 49yo, M | LOC | Complete recovery after 3 mo. | Serum toxicology: positive for methadone | Not mentioned | T2 and FLAIR: high in white matter of right cerebellum and deep gray and white matter of both cerebral hemispheres. |
R.A. Salgado et al. (2009) [5] | 65yo, F | Apathy, a catatonic state with extreme rigidity, reflexes in the upper limbs, and a bilaterally positive Babinski sign | In the following month, the patient slowly recovered. | Serum and urine toxicology shows large amount of methadone | Day 27 | FLAIR and T2: symmetric signal intensity abnormality in the deep white matter of both cerebral hemisphere with sparing of sub cortical U-fibers without corresponding diffusion restriction |
Rando J. (2016) [1] | 14yo, M | Hypothermia, HTN, respiratory depression | Aphasia, truncal ataxia | Serum toxicology: positive for methadone | In admission day | FLAIR: cereberallitis |