Cocaine-induced multifocal leukoencephalopathy mimicking Balo's concentric sclerosis: A 2-year follow-up with serial imaging of a single patient

Sagduyu K., Yalinay D., Karaarslan E.

MULTIPLE SCLEROSIS AND RELATED DISORDERS, vol.19, pp.96-98, 2018 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Editorial Material
  • Volume: 19
  • Publication Date: 2018
  • Doi Number: 10.1016/j.msard.2017.11.011
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.96-98
  • Keywords: Cocaine, Leukoencephalopathy, Magnetic resonance imaging, Balo's concentric sclerosis, Levamisole
  • Acibadem Mehmet Ali Aydinlar University Affiliated: Yes


Cocaine abuse may cause stroke, metabolic or multifocal inflammatory leukoencephalopathy. We described a patient with cocaine abuse who presented with Balo's type acute multifocal leukoencephalopathy. Magnetic Resonance Imaging (MRI) of the brain showed onion like patchy concentric ring enhancement on T1-weighted MRI with gadolinium. Balo's Concentric Sclerosis like radiological findings related to cocaine has not been reported. Levamisole is now frequently used as an ingredient in cocaine and may cause leukoencephalopathy. It is recommended to check urine levamisole levels in patients with cocaine-induced leukoencephalopathy with or without mimicking Balo's Concentric Sclerosis. On the other hand, it is also possible that the cocaine use was coincidental and this was a demyelinating case arising de novo in patient who uses cocaine.