A person who chronically abuses heroin may suddenly develop an acute myelopathy.
Some patients give a history of recent use after a period of abstinence.
Clinical features:
(1) initial flaccid paraparesis or paraplegia of sudden onset
(2) sensory loss in legs and lower torso dermatomes
(3) urinary sphincter disturbances
(4) noninflammatory CSF findings
Some patients recover completely while others suffer a complication.
Complications:
(1) residual spastic paraparesis
(2) residual sensory deficit
(3) death
