{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T07:06:04Z","timestamp":1790319964575,"version":"4.1.0"},"reference-count":32,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>The opioid crisis has become a significant public health concern in recent years. Although respiratory depression and overdose are the most reported side effects of fentanyl, there have been rare cases of cerebellar leukoencephalopathy (CLE) following fentanyl intoxication. A 29-year-old man with a history of opioid use disorder and intravenous drug use presented to the emergency room with significant ataxia and dysarthria following fentanyl intoxication. According to the patient, the symptoms began four days prior after \u201cchasing the dragon\u201d with \u201cpure fentanyl\u201d, and he reported experiencing nausea and dizziness, particularly during ambulation. Neurological examination revealed a positive Romberg test, ataxia, and delayed speech. Brain magnetic resonance imaging (MRI) indicated there was toxic degeneration of the cerebellar white matter that extended into the posterior limbs of the internal capsule. Urine drug screening was positive for opioids, making fentanyl-induced cerebellar leukoencephalopathy the most likely diagnosis in this case. This case of opioid-induced CLE underscores the critical significance of early recognition, which is vital for enhancing a patient\u2019s recovery and averting the development of severe neurological complications.<\/jats:p>","DOI":"10.5339\/qmj.2023.36","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T03:30:26Z","timestamp":1704857426000},"source":"Crossref","is-referenced-by-count":4,"title":["Cerebellar Leukoencephalopathy following Fentanyl Intoxication. A case report and review of the literature"],"prefix":"10.5339","volume":"2023","author":[{"given":"Hamzah Adel","family":"Ramawad","sequence":"first","affiliation":[{"name":"NYC Health & Hospital, South Brooklyn Health, Brooklyn, New York, USA Email: hamzahr.adel@gmail.com ORCID iD: 0000-0002-9687-3599"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amirmohammad","family":"Toloui","sequence":"additional","affiliation":[{"name":"Iran University of Medical Science, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Chen","sequence":"additional","affiliation":[{"name":"New York Institute of Technology College of Osteopathic Medicine, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Sun","sequence":"additional","affiliation":[{"name":"NYC Health & Hospital, South Brooklyn Health, Brooklyn, New York, USA Email: hamzahr.adel@gmail.com ORCID iD: 0000-0002-9687-3599"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3277","reference":[{"key":"CIT0001","article-title":"National Center for Health Statistics Mortality Data on CDC WONDER","author":"US Department of Health and Human Services, CDC  [Internet]","year":"c2021"},{"issue":"(3):","key":"CIT0002","series-title":"Can J Neurol Sci","first-page":"398-399","article-title":"Fentanyl overdose causing Hippocampal Ischaemia followed by delayed Leukoencephalopathy","volume":"47","author":"Switzer\n \nAR","year":"2020"},{"issue":"(4):","key":"CIT0003","series-title":"Taehan Yongsang Uihakhoe Chi","first-page":"972-978","article-title":"\ud39c\ud0c0\ub2d0 \ucca9\ud3ec \ub0a8\uc6a9\uc73c\ub85c \uc778\ud55c \uc9c0\uc5f0\uc131 \uc800\uc0b0\uc18c\uc131 \ubc31\uc0c9\uc9c8\ub1cc\uc99d: \uc99d\ub840 \ubcf4\uace0 [Delayed Post-Hypoxic Leukoencephalopathy Induced by an Overdose with Fentanyl Patches: A Case Report]","volume":"81","author":"Choi\n \nJS","year":"2020"},{"issue":"(9):","key":"CIT0004","series-title":"Pediatr Emerg Care","first-page":"854-6","article-title":"Toxic leukoencephalopathy due to transdermal fentanyl overdose","volume":"27","author":"Foy\n \nL","year":"2011"},{"issue":"(6):","key":"CIT0005","series-title":"AJNR Am J Neuroradiol","first-page":"1073-1079","article-title":"MRI Shrimp Sign in Cerebellar Progressive Multifocal Leukoencephalopathy: Description and Validation of a Novel Observation","volume":"42","author":"Adra\n \nN","year":"2021"},{"issue":"(6):","key":"CIT0006","series-title":"Addiction","first-page":"673-83","article-title":"Heroin smoking by \u2018chasing the dragon\u2019: origins and history","volume":"92","author":"Strang\n \nJ","year":"1997"},{"issue":"(4):","key":"CIT0007","series-title":"Dement Neurocogn Disord","first-page":"170-172","article-title":"Delayed Post-Hypoxic Leukoencephalopathy Caused by Fentanyl Intoxication in a Healthy Woman","volume":"19","author":"Kim\n \nJ","year":"2020"},{"issue":"(5):","key":"CIT0008","series-title":"Neuroradiol J","first-page":"386-391","article-title":"Malignant cerebellar edema in three-year-old girl following accidental opioid ingestion and fentanyl administration","volume":"32","author":"Chen\n \nCH","year":"2019"},{"issue":"(1):","key":"CIT0009","series-title":"Neurohospitalist","first-page":"109-110","article-title":"Opioid-Associated Amnestic Syndrome Progressing to Diffuse Leukoencephalopathy","volume":"13","author":"Meng\n \nD","year":"2023"},{"issue":"(11):","key":"CIT0010","series-title":"Neuroradiology","first-page":"845-8","article-title":"Unusual pattern of leukoencephalopathy after morphine sulphate intoxication","volume":"42","author":"Nanan\n \nR","year":"2000"},{"issue":"(12):","key":"CIT0011","series-title":"Heliyon","first-page":"e03005","article-title":"Opioid-induced toxic leukoencephalopathy: A case report and review of the literature","volume":"5","author":"Wheaton\n \nT","year":"2019"},{"key":"CIT0012","series-title":"In: Encyclopedia of the Neurological Sciences","first-page":"878\u20139","article-title":"Leukoencephalopathy","author":"Aminoff\n \nMJ","year":"2014"},{"issue":"(1):","key":"CIT0013","series-title":"Pediatr Rheumatol Online J","first-page":"58","article-title":"Leukoencephalopathy and cerebral edema as the presenting manifestations of SLE in an ANA-negative adolescent female: a case report and review of literature","volume":"18","author":"Theisen\n \nA","year":"2020"},{"key":"CIT0014","first-page":"21","article-title":"Opioid Overdose","author":"Schiller\n \nEY","year":"2023"},{"key":"CIT0015","series-title":"Cerebral Edema","first-page":"3","author":"Nehring\n \nSM","year":"2023"},{"issue":"(S3):","key":"CIT0016","series-title":"Physiol Res","first-page":"S289-S300","article-title":"Effect of methylprednisolone on experimental brain edema in rats - 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