Clinical findings may include:
(1) limb weakness with inability to stand
(2) progressive sluggishness or catatonia
(3) impulsivity
(4) decreased level of consciousness
Imaging studies of CNS:
(1) hypodense white matter on CT
(2) long T1 and T2 signals in white mater on MRI
(3) abnormalities in diffusion tensor imaging
Biopsy findings:
(1) white matter rarefaction
(2) loss of myelin
(3) axonal injury
Differential diagnosis:
(1) infectious encephalopathy (HIV, other)
(2) toxic encephalopathy due to other drugs of abuse (heroin, alcohol, cocaine, toluene, etc)
(3) drug-induced vasculitis
(4) withdrawal reaction
