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Guide Complications (The Complicated Series)

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The patients' ages ranged between 20 and 38 years and the duration of consumption was between 2 and 6 years. The primary mode of consumption was inhalation of vapours formed from opium heated on an aluminum foil; 3 patients also had a history of intravenous use.


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One of these patients had a history of co-morbid benzodiazepine dependence; the rest denied any history of benzodiazepine abuse or dependence. Laboratory investigations to confirm this could not be carried out. All 7 patients denied history of alcohol use, which was confirmed by urinary tests for alcohol. The caretakers of the patients confirmed the patients' histories regarding co-morbid substance dependence. None of the 7 patients had any prior history of head injury, convulsions or any other disease.

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Routine blood parameters were within the normal ranges. Medications used for the management of withdrawal prior to the development of complications included either substitution with dextro-propoxyphene or benzodiazepines or haloperidol for behavioural management. CT scan done on a delirious patient and electroencephalography of a patient with convulsions did not reveal any abnormality. All the patients recovered with no clinical evidence of any neurological sequelae.

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In view of these unreported complications, an attempt was made to obtain the opioid consumed by these patients; however, this proved fruitless. The opioid that all the patients consumed was the street variety, which is generally contaminated. Complications such as convulsions and delirium are recognized in alcohol withdrawal. However, these have not been described as a feature of opioid withdrawal. In these 7 patients, all the likely causes of these complications were ruled out, and opioid withdrawal emerged as a probable cause of these complications.

There is, however, no literature on the subject. Neonatal abstinence syndrome NAS due to opiate withdrawal in infants of opioid-dependent mothers is known to result in epileptiform activity with seizures that may be generalized and myoclonic. Although the majority of opioid withdrawal symptoms are somatic in nature, various neurological conditions have also been described in patients with opioid dependence.

Two unusual cases of opioid dependence who developed neurological complications have been detailed by Celius. Rhabdomyolysis presenting as mononeuropathy, plexus lesions 5 and transverse myelitis 6 has been reported in heroin addicts. Nearly 1 to 3 of every 1, children who become infected with measles will die from respiratory and neurologic complications.

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Measles may cause pregnant women who have not had the MMR vaccine to give birth prematurely, or have a low-birth-weight baby. Subacute sclerosing panencephalitis SSPE is a very rare, but fatal disease of the central nervous system that results from a measles virus infection acquired earlier in life. See additional photos of what measles look like at different stages after symptoms begin.

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Complications of Measles. Minus Related Pages. Allergy Rhinol Providence. Dutta M Ghatak S. J Clin Diagn Res. Epub Dec Piromchai P Thanaviratananich S. Invasive fungal rhinosinusitis versus bacterial rhinosinusitis with orbital complications: a case-control study. Scientific World Journal. Hosemann W Draf C. Danger points complications and medico-legal aspects in endoscopic sinus surgery.

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Entire Site De Gruyter Online. Sign in Register. English Deutsch. Odontogenic suppurative rhinosinusitis with oculo-orbital and cerebral complications - case series. Daniela Vrinceanu 1 , Mihai Dumitru orldumitrumihai yahoo.


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Open access. Keywords: odontogenic suppuration ; surgery ; complications ; multidisciplinary team.