{"pk":727,"title":"Opioid Overdose With Parkinsonian Features","subtitle":null,"abstract":"A 54-year-old man presented to the emergency department with confusion and Parkinsonian features after suspected heroin snorting. He had magnetic resonance imaging of the brain demonstrating isolated symmetric bilateral globus pallidus (GP) restricted diffusion and edema consistent with hypoxic ischemic encephalopathy. In contrast to other anoxic/ischemic insults, where the GP is preferentially spared, autopsy reports on intravenous heroin users have found the GP to be specifically affected, often demonstrating symmetric bilateral lesions. Opioid toxicity should be considered in patients presenting with Parkinsonian features on examination or pallidal lesions on imaging, especially in younger adults where infarction is less common.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/4v04g7t4","frozenauthors":[{"first_name":"Paul","middle_name":"","last_name":"Cohen","name_suffix":"","institution":"Brown University, Department of Emergency Medicine, Providence, Rhode Island","department":"None"},{"first_name":"Jason","middle_name":"B.","last_name":"Hack","name_suffix":"","institution":"Brown University, Department of Emergency Medicine, Division of Medical Toxicology, Providence, Rhode Island","department":"None"}],"date_submitted":"2019-10-14T20:03:32-04:00","date_accepted":"2019-10-14T20:03:32-04:00","date_published":"2019-10-14T20:04:15-04:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/727/galley/482/download/"}]}