• Yazmin Morales Odia, Madhavi Jinka, and Wendy C Ziai.
• Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
• Neurocrit Care. 2010 Aug 1; 13 (1): 93-7.

BackgroundPost-opioid toxic encephalopathy is described associated with the synthetic opioid, methadone, and after heroin intoxication, (inhaled, injected or ingested).MethodsWe describe the clinical and radiologic findings of a 46-year-old man with oxycodone and oxycontin overdose who developed multifocal encephalopathy and severe cerebellitis causing acute obstructive hydrocephalus, and discuss the possible mechanisms involved.ResultsBrain MRI showed a non-vascular distribution of diffusion positive lesions in both cerebellar hemispheres and globi pallidi with preserved cerebral perfusion, suggesting an inflammatory process. Management required ventilatory support and intraventricular catheter placement.ConclusionsTo our knowledge, this is the first report of this condition associated with oxycodone and oxycontin ingestion. The occurrence of this rare toxic encephalopathy may be related to distribution patterns of opioid receptor subtypes, genetic susceptibility, sensitization, and other specific comorbidities.

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