• Maryam Haghighi-Morad, Nasim Zamani, Hossein Hassanian-Moghaddam, and Maziar Shojaei.
• Department of Radiology, Loghman-Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
• Bmc Neurol. 2020 May 1; 20 (1): 166.

BackgroundEncephalopathy is an uncommon but serious presentation of lead toxicity.ObjectiveWe aimed to determine and follow-up the brain magnetic resonance imaging (MRI) abnormalities in the patients with lead encephalopathy due to ingestion of lead contaminated opium.MethodsIn a cross-sectional study during lead-contaminated opium outbreak, all lead-poisoned patients with any signs/symptoms of encephalopathy were included.ResultsOf 19 patients with lead encephalopathy, five died early and other five could not be sent to MRI during their hospitalization period. Mean age was 51 ± 11 years and males were dominant (89%). Median [IQR] blood lead level (BLL) was 101 [81, 108] μg/dL (range; 50 to 200 μg/dL). There was no correlation between MRI findings and signs/symptoms. MRI was normal in six and abnormal in three. Bilateral symmetric involvement of parieto-occipital lobes was observed. Gray matter, gray-white matter junction, and subcortical white matter were also affected. Follow-up MRI was performed in two with abnormal MRI which showed complete and near complete resolution of the abnormalities after cessation of opium use and treatment.ConclusionThere was no correlation between MRI findings and BLL. Complete recovery of brain MRI lesions was detected after cessation of opium use.

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