Neurological complications of drug abuse

Widespread drug abuse, a comparatively recent medicosocial phenomenon, presents protean clinical patterns and challenging diagnostic problems daily that mimic classical medical syndromes. However, few reports have delineated predominantly neurologic syndromes associated with drug abuse. Five patients were observed illustrating the critical importance of considering drug abuse in the differential diagnosis of neurologic disease, particularly in the young population. It has been found that attention directed to four sources of information will substantiate the diagnosis of drug abuse in the large majority, thus expenditing the prompt initiation of appropriately directed treatment. In addition careful history and neurologic examination, a routine screeen of blood and urine should be run for barbiturates, bromides, alcohol and salicylates. An electroencephalogram is highly recommended as an initial study. It is informative, non-traumatic and inexpensive. Low voltage fast activity is consistent with drug effect and usually rules out other metabolic causes of coma. Other diagnostic principles are enumerated and illustrative cases are cited.