Neurological aspects of drug misuse.

IF 2.4 Q2 CLINICAL NEUROLOGY
Robin S Howard, Paul Holmes, Paul Dargan
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Abstract

The misuse of illicit drugs and prescription medications may cause neurological complications from overdose, withdrawal and long-term chronic misuse. Drug-use disorder has become particularly important and complex because of different patterns of presentation associated with new psychoactive substances and the growing misuse of opioids, synthetic cannabinoids and stimulants. We review worldwide demographic data of drug-use disorder and discuss the individual classes of agents, newer developments relating to understanding the mechanisms of action and the patterns of administration, usage, toxicity and withdrawal. We consider the difficulties in assessment and the specific acute syndromes of toxicity that present with neurological manifestations. We review the neurological patterns of longer-term complications and consider the effects of drug misuse-related trauma, infection, seizures, stroke, toxic leucoencephalopathy, cognitive impairment, movement disorders and neuromuscular complications. The neurological consequences of drug-use disorder disproportionately affect the young and can have devastating effects on innocent lives. It is essential that neurologists recognise acute toxicity early and understand the longer-term consequences of drug-use disorder.

药物滥用的神经学方面。
滥用非法药物和处方药可因过量、停药和长期慢性滥用而引起神经系统并发症。由于与新的精神活性物质有关的不同表现形式以及类阿片、合成大麻素和兴奋剂的滥用日益增加,药物使用障碍已变得特别重要和复杂。我们回顾了世界范围内药物使用障碍的人口统计数据,并讨论了药物的各个类别,与理解作用机制和给药、使用、毒性和停药模式有关的最新发展。我们考虑的困难,在评估和毒性的具体急性综合征,目前与神经系统的表现。我们回顾了长期并发症的神经学模式,并考虑了药物滥用相关的创伤、感染、癫痫、中风、中毒性白质脑病、认知障碍、运动障碍和神经肌肉并发症的影响。毒品使用障碍的神经后果对年轻人的影响尤为严重,并可能对无辜的生命造成毁灭性的影响。神经学家必须及早认识到急性毒性,并了解药物使用障碍的长期后果。
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来源期刊
PRACTICAL NEUROLOGY
PRACTICAL NEUROLOGY Medicine-Neurology (clinical)
CiteScore
3.70
自引率
3.60%
发文量
113
期刊介绍: The essential point of Practical Neurology is that it is practical in the sense of being useful for everyone who sees neurological patients and who wants to keep up to date, and safe, in managing them. In other words this is a journal for jobbing neurologists - which most of us are for at least part of our time - who plough through the tension headaches and funny turns week in and week out. Primary research literature potentially relevant to routine clinical practice is far too much for any neurologist to read, let alone understand, critically appraise and assimilate. Therefore, if research is to influence clinical practice appropriately and quickly it has to be digested and provided to neurologists in an informative and convenient way.
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