Pathological Changes in Heroin-induced Spongiform Leukoencephalopathy and Therapeutic Effect of Comprehensive Rehabilitation： A Follow-up Study （Abstract）

Objective： To explore the pathological mechanism and effective comprehensive rehabilitation protocol of heroin-induced spongiform leukoencephalopathy （HSLE）. Method： Four patients with HSLE received comprehensive rehabilitation treatment including medication with dexametasone, encephalon polytide, cytidine diphosphate choline, and Vitamin B, intravascular irradiation with low-energy laser, hyperbaric treatment, balance training, acupuncture, and psychological consultation, etc and the therapeutic effects were observed to formulate the optimal comprehensive rehabilitation treatment protocol. Results： Clinical assessment was performed 10 weeks after treatment, which yielded significant improvement in cognition, psychology, linguistic ability, balance, as well as walking and ability to perform daily activities. The scores of Changguchun scale were 9, 8, 28 and 26 respectively before treatment for the 4 cases, while 35, 32, 35 and 35 respectively after treatment. The symptoms of drug abstinence, addiction and desire disappeared in case 1 and 2. Linguistic abilities were improved in 3 patients. In balance response examination, patient 1 scored 18 after treatment vs 3 before treatment, and the other 3 patients scored 20 vs 7, 16 vs 10, and 17 vs 11 respectively. The MBI scores for activity of daily life were 95 after treatment vs 35 before treatment in case 1, 100 vs 40 in case 2, 90 vs 30 in case 3, and 95 vs 40 in case 4. Conclusion： Comprehensive rehabilitation benefits the recovery of patients with HSLE. The pathological mechanism of HSLE involves not only the central nervous demyelination and immune response, but also cerebral ischemia and hypoxia.