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Multifocal leukoencephalopathy in cocaine users: a report of two cases and review of the literature

Overview of attention for article published in BMC Neurology, October 2015
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (85th percentile)
  • High Attention Score compared to outputs of the same age and source (84th percentile)

Mentioned by

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1 news outlet
twitter
3 tweeters
reddit
1 Redditor

Citations

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23 Dimensions

Readers on

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54 Mendeley
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Title
Multifocal leukoencephalopathy in cocaine users: a report of two cases and review of the literature
Published in
BMC Neurology, October 2015
DOI 10.1186/s12883-015-0467-1
Pubmed ID
Authors

Reza Vosoughi, Brian J. Schmidt

Abstract

Cocaine abuse is associated with several mechanisms of brain injury including ischemic, hemorrhagic and metabolic. Recently two case reports of leukoencephalopathy in cocaine users implicated a commonly used cocaine adulterant, levamisole. One well-documented adverse effect of levamisole, when used alone as antihelminthic or immunomodulatory drug, is multifocal inflammatory leukoencephalopathy. Therefore, immune mechanisms may also contribute to cocaine-induced brain injury. Two cocaine users with multifocal leukoencephalopathy, treated with steroids and plasmapheresis, are described. The first is a 25-year-old man who presented with unilateral motor and sensory impairment progressing to bilateral deficits, dysphagia, dysarthria and confusion over several days. Serial MRI showed increasing abnormal FLAIR signal lesions with patchy restricted diffusion and heterogenous enhancement deep in the right and left hemispheres, including periventricular white matter as well as in the pons and cerebellar peduncle. The second patient is a 41-year-old woman who presented with confusion and impaired balance. MRI showed bilateral periventricular FLAIR lesions with scattered restricted diffusion and subtle gadolinium enhancement of some of the lesions. She initially stabilized with supportive care only, but after further cocaine use was re-admitted six weeks later with marked neurological deterioration and MRI showed prominent worsening of the lesions. Both patients received steroid and plasma exchange and showed substantial improvement clinically and on imaging, which was sustained during out-patient follow-up. Multifocal leukoencephalopathy associated with cocaine use may have an inflammatory/immune basis, possibly related to levamisole contamination, at least in some patients. Three cases, including the present two, have been described wherein good neurological improvement was seen in association with steroid treatment. However, in the absence of appropriate clinical trials, it remains unknown whether immunotherapy is truly beneficial for these patients.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 54 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Switzerland 1 2%
Unknown 53 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 7 13%
Student > Ph. D. Student 6 11%
Student > Postgraduate 6 11%
Student > Master 6 11%
Student > Bachelor 4 7%
Other 14 26%
Unknown 11 20%
Readers by discipline Count As %
Medicine and Dentistry 23 43%
Neuroscience 7 13%
Psychology 3 6%
Nursing and Health Professions 2 4%
Immunology and Microbiology 2 4%
Other 3 6%
Unknown 14 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 11. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 January 2021.
All research outputs
#2,005,690
of 16,621,802 outputs
Outputs from BMC Neurology
#226
of 1,856 outputs
Outputs of similar age
#42,369
of 287,791 outputs
Outputs of similar age from BMC Neurology
#29
of 197 outputs
Altmetric has tracked 16,621,802 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,856 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.0. This one has done well, scoring higher than 87% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 287,791 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 85% of its contemporaries.
We're also able to compare this research output to 197 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 84% of its contemporaries.