• A B Gekht, A G Polunina, E A Briun, and E I Gusev.
• Zh Nevrol Psikhiatr. 2003 Jan 1;103(2):9-15.

AbstractNeurological examination was performed in 79 heroin addicts (mean age 24.4 +/- 6.3 years; heroin abusing duration 16.6 +/- 12.4 months; heroin dose per day 0.48 +/- 0.42 grams). During the first week after withdrawal, "physical dependency" symptoms, mild hypomimia and hypokinesia, low muscle tone, low tendon reflexes and facilitated nociceptive reflexes were observed in more than 70% of the patients. Non-specific microneurological signs as nystagm, limited convergence, tremor and dynamic ataxia etc, were found in more than 35% of the cases. Previously reported meningeal irritation or polyneuropathy symptoms were not determined in the patients population. Most of the symptoms disappeared after 10 days of abstinence as the follow-up examination of the 34 patients revealed. Mild hypomimia and hypokinesia persisted along with characteristic psychopathological changes. The most abundant neurological disturbances were observed in patients abusing heroin for more than 6 months in dosages more than 0.4 grams per day. Heroin withdrawal symptoms include reversible decrease in muscle tone and tendon reflexes as well as facilitation of nociceptive reflexes and reversible non-specific neurological microsigns. Heroin encephalopathy is characterized by ventral striatum insufficiency signs.

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