Toluene related leukoencephalopathy
Young Malay man with chronic toluene misuse. Presented with cerebellar dysfunction.
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MRI of the brain demonstrates extensive increased T2 signal in the white matter extending from the centrum semiovale, down the posterior limb of the internal capsule and through the anterolateral pons, as well as the white matter of the cerebellar hemispheres.
Additionally low signal is seen in the deep grey matter structures, particularly involving the thalami, globus pallidi and dentate nuclei, as well as the red nuclei and substantia nigra.
Widespread cerebral and cerebellar volume loss is also present with marked thinning of the corpus callosum, without T2 signal change.
This case illustrates widespread changes consistent with the known history of solvent inhalational abuse (toluene).
- Mohd Isa, M.F. et al., 2013. Toluene dependency, psychosis, and cerebellar syndrome. The Journal of neuropsychiatry and clinical neurosciences, 25(2), pp.E42–3.