|
| Publication | No. of the subjects | Age (y) | Time to the symptoms | Initial symptoms | MRI findings | Treatment | Outcome |
|
| Levin 2005 [33] | 21 | 15–36 (21 ± 5.8) | 3–14 (6.8 ± 4.9) months | Disorders of speech (33%) and gait (29%), fatigue (29%), bradykinesia (14%), affective symptoms (19%) | T1 bilateral symmetric SI in GPi, SNr—18 (86%); no correlation with duration of usage, dosage nor severity of the symptoms | EDTA, l-dopa, clonazepam, amantadine | Spontaneous regression of the symptoms—29%, worsening—33% even after 4 y abstinence |
|
Sikk et al. 2007, 2010 [14, 34] | 4 (case reports) | 24–42 | 6 months–8 y | Gait disorder—2, hypophonia—2 | T1 SI increase in GP, putamen, NCh—2 cases; decrease of SI in the same areas—1 | Not reported | Initial improvement then stable—1, stable still using—1, slow progression of the symptoms—2 |
|
De Bie et al. 2007 [19] | 1 (case report) | 36 | Not exactly reported, possibly 4–16 months | Decrease of libido; sleepiness, slowness | Symmetric SI increase in GP, SN dentate nucleus, and pontine tegmentum | Pramipexole, selegiline, l-dopa | No improvement |
|
Sanotsky et al. 2007 [15] | 6 (case reports) | 23–45 | 2 months–1 y | Speech and gait disorder—1, plus bradyphrenia or depression—2, slowness—2, hyperthermia—1 | Striking bilateral SI increase of lentiform nucleus, SN, dentate nucleus | EDTA, cerebrolysin, amantadine, l-dopa | Mild to moderate improvement—4, no improvement—2 |
|
Meral et al. 2007 [35] | 2 (case reports) | 21 and 32 | Unknown, 4 months | Bradykinesia, gait and speech disorders | Bilateral SI increase in GP. After withdrawal of injections, improvement of MRI in case 2 | Not reported | No improvement |
|
Stepens et al. 2008 [17] | 23 | 37.5 ± 6.5 | 5.8 ± 4.5 y | Gait disturbance—20 (87%), hypophonia—3 (13%) | T1 SI increase in GP—all 10 active users, in SN—9; former users had lesser degrees of change (SI increase in GP—11, SN—2, anterior midbrain—3) | L-dopa in 3 patients | No substantial improvement in 13 subjects after withdrawal for 2–6 y |
|
Selikhova et al. 2008 [16] | 13 | 18–46 (29.9) | 8.5 ± 3.2 months | Loss of balance—7, slurred speech—4, mood disorders—2 | T1 SI increase mostly in GPi,—all; other frequently involved structures—STN, SNr, putamen | L-dopa, amantadine, EDTA, | Significant residual deficit; delayed progression in some cases |
|
Colosimo and Guidi 2009 [18] | 1 (case report) | 28 | 2 y | Gait and speech disturbance, mental slowness, generalized fatigue | Repeated MRI normal | Not reported | Some deterioration of motor signs |
|
Yildirim et al. 2009 [36] | 1 (case report) | 29 | 9.5 y since start of abuse, 5 y abstinence | Gate disturbance, mood disorders | Normal | Piracetam, carbamazepine, fluoxetine, l-dopa | Gradual worsening over time |
|
Varlibas et al. 2009 [37] | 3 (case reports) | 15–19 | 2–6 y | Postural instability, face and limb dystonias, tremor, dysphonia, dysarthria, bradykinesia | Bilateral symmetric SI increase in dentate nucleus, white matter of cerebellum, GP and putamen | EDTA, PAS, l-dopa | No improvement |
|
