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Emergency: requires immediate attention
Toxic leukoencephalopathy
Other Resources UpToDate PubMed
Emergency: requires immediate attention

Toxic leukoencephalopathy

Contributors: Andrea Wasilewski MD, Richard L. Barbano MD, PhD
Other Resources UpToDate PubMed

Synopsis

Toxic leukoencephalopathy is structural damage to the cerebral white matter as a result of exposure to a toxic substance. Damage occurs secondary to disruption of central nervous system myelin. Toxic leukoencephalopathy can occur after exposure to multiple agents including cranial radiation, chemotherapeutic agents, immunosuppressive drugs, antifungal agents, alcohol, illicit drugs, and environmental toxins such as carbon monoxide. Patients of any age can be affected after exposure to a leukotoxic agent. Symptoms may be acute and temporally related to a toxic exposure but are often chronic or delayed. Hypoxia from carbon monoxide poisoning, for example, can cause delayed posthypoxic leukoencephalopathy, as can drug overdoses, complications of general anesthesia, asphyxiation from strangulation, and hemorrhagic shock.

Patients may present with a variety of neurologic symptoms including behavioral or personality changes, memory impairment, and language and cognitive dysfunction. Focal symptoms are an uncommon finding. Due to nonspecific findings, patients may be misdiagnosed with psychiatric disease. Prognosis depends on the particular leukotoxin the patient was exposed to, the duration of exposure, and the degree of injury. While improvement often occurs, recovery is rarely complete.

Codes

ICD10CM:
R90.82 – White matter disease, unspecified

SNOMEDCT:
722602003 – Toxic leukoencephalopathy

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

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Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

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References

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Last Reviewed:04/30/2019
Last Updated:09/23/2021
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Emergency: requires immediate attention
Toxic leukoencephalopathy
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A medical illustration showing key findings of Toxic leukoencephalopathy : Chemical substance abuse, Memory impairment, Mental status alteration, Personality changes, Chemical compound exposure, Therapeutic radiation exposure, Cognitive impairment, Delirium/Confusion
Copyright © 2024 VisualDx®. All rights reserved.