scholarly journals Bilateral Basal Ganglia Lesions in Patients with Heroin Overdose: A Report of Two Cases

2019 ◽  
Vol 2 (3) ◽  
pp. 62-68 ◽  
Author(s):  
Ali Hassan ◽  
Mahdi Al Jawad ◽  
Amna Alsaihati ◽  
Haitham Alaithan ◽  
Faisal Al Hawaj
Keyword(s):  
Basal Ganglia ◽  
Vegetative State ◽  
Opioid Use Disorder ◽  
Deep Coma ◽  
Opioid Use ◽  
Male Patients ◽  
Related Individuals ◽  
Unconscious Patients ◽  
Supportive Management ◽  
Preceding Event

The prevalence of opioid use has increased worldwide. Two-thirds of deaths caused by drug overdose are opioid-related. Individuals with opioid use may present with a variety of complications. The available history in unconscious patients is often insufficient, which may cause diagnostic difficulty and delayed management. We present two cases of 54-year-old and 25-year-old male patients who were brought to our emergency department after being found unconscious at home, without any known preceding event. They were in a deep coma with a Glasgow coma score of 3/15. However, their brainstem reflexes were normal. Pinpoint pupils were observed bilaterally. Brain computed tomography (CT) demonstrated the presence of bilateral basal ganglia hypodensities in both patients, in addition to multiple hypodensities scattered in the cerebral hemispheres of one patient. Toxicology screening from both patients was positive for opioids. The patients were transferred to the intensive care unit for supportive management. One patient recovered completely, whereas the other remained in a vegetative state. The presence of bilateral basal ganglia lesions in brain CT in unconscious patients should alert the physician of opioid use disorder among these patients.

Using Bilateral tDCS to Modulate EEG Amplitude and Coherence of Men With Opioid Use Disorder Under Methadone Therapy: A Sham-controlled Clinical Trial

2021 ◽  
pp. 155005942110221
Author(s):  
Hossein Mostafavi ◽  
Mohsen Dadashi ◽  
Alireza Faridi ◽  
Fatemeh Kazemzadeh ◽  
Zakaria Eskandari
Keyword(s):  
Clinical Trial ◽  
Quantitative Eeg ◽  
Opioid Use Disorder ◽  
Controlled Clinical Trial ◽  
Opioid Use ◽  
Double Blind ◽  
Theta Waves ◽  
Dorsolateral Prefrontal ◽  
Male Patients ◽  
The Right

Objective. This study aimed to investigate the effect of bilateral transcranial direct current stimulation (tDCS) on the electroencephalography (EEG) amplitude and coherence in male patients with opioid use disorder (OUD), who were under methadone therapy. It compares the effects of active versus sham tDCS. Methods. This is a double-blind sham-controlled clinical trial. Participants were 30 male patients with OUD; they were divided into 3 groups of left anode/right cathode tDCS, right anode/left cathode tDCS, and sham tDCS. Their brainwave activity was measured by quantitative EEG before study and then active groups underwent tDCS (2 mA, 20 min) applied over their right/left dorsolateral prefrontal cortex (DLPFC) for 10 consecutive days. After stimulation, they were re-assessed. The collected data were analyzed in SPSS, MATLAB, and NeuroGuide v.2 applications. Results. After active tDCS, a significant decrease in amplitude of slow brain waves (delta, theta, and alpha) in prefrontal, frontal, occipital, and parietal areas, and an increase in the coherence of beta, delta, and theta frequency bands in the parietal, central, and temporal regions of addicts were reported. In the sham group, there was a significant decrease in the amplitude of the alpha wave and in the coherence of delta and theta waves. Conclusion. The active tDCS over the right/left DLPFC, as a noninvasive and complementary treatment, can modulate the amplitude and coherence of brainwaves in patients with OUD.

L'esperienza clinica con Levometadone nel trattamento del disturbo da uso di oppiacei

MISSION ◽  
2019 ◽  
pp. 54-57
Author(s):  
Marco Riglietta ◽  
Paolo Donadoni ◽  
Grazia Carbone ◽  
Caterina Pisoni ◽  
Franca Colombi ◽  
...  
Keyword(s):  
Adverse Events ◽  
Real Life ◽  
Opioid Use Disorder ◽  
Racemic Mixture ◽  
Opioid Use ◽  
The Real ◽  
New Formulation

In Italy, at the end of the 1970s, methadone hydrochloride was introduced for the treatment of opioid use disorder, in the form of a racemic mixture consisting of levomethadone and dextromethadone.In 2015 Levometadone was introduced, a new formulation marketed in Italy for the treatment of opioid use disorder in 2015.The article aims to bring the experience of an Italian Addiction Centre back to the use of this new formulation in the "real life" analyzing the efficacy, the trend of adverse events and pharmacological iterations in a context in which the treated population often uses besides the opiates, cocaine and alcohol, are burdened by a relevant physical and psychic comorbidity and frequently have a prescribed polypharmacy.

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