A fatal case of spongiform leukoencephalopathy linked to 'chasing the dragon'

Background: 'Chasing the dragon' involves placing heroin on aluminum foil, heating it from below with a flame, and inhaling the pyrolysate through a straw. It has rarely been associated with the development of a progressive spongiform leukoencephalopathy. Case Report: A 43-year-old woman presented with 2 weeks of bizarre behavior, forgetfulness, and slowed speech and movements. Serum, cerebrospinal fluid, and head computed tomography (CT) scan were normal. The patient progressed to coma and expired during week 4 of hospital admission. The family confirmed that she 'chased the dragon.' Cause of death at post mortem examination was spongiform leukoencephalopathy. Conclusion: The diagnosis of heroin pyrolysate-induced spongiform leukoencephalopathy should be considered in a patient with a history of 'chasing the dragon' and neurobehavioral changes, including confusion, apathy, cerebellar signs, and motor restlessness. Key Words: 'Chasing the dragon'; Spongiform leukoencephalophy; Heroin pyrolysate.
INTRODUCTION 'Chasing the dragon' involves placing heroin on aluminum foil, heating it from below with a flame, and inhaling the pyrolysate through a straw. First described in Hong Kong in [...]