Toxic leukoencephalopathy (mnemonic)

Last revised by Joshua Yap on 25 Jul 2022

A mnemonic to remember the more common causes of toxic leukoencephalopathy is:

  • CHOICES​ 1


  • C: chemotherapy (e.g. methotrexate)
  • H: heroin
  • O: other opioids
  • I: immunosuppressant drugs or imidazole
  • C: cocaine
  • E: ethanol or environmental (e.g. carbon monoxide)
  • S: splenial lesions (reversible secondary to: CLOCCs, antiepileptic drugs, chemotherapy, immunosuppressant drugs, etc.)

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