MRI scans have revealed the potentially life-threatening impact of regular cocaine use on the brain.

The scans were taken after a 45-year-old man who was a regular cocaine user showed up in A&E with confusion and unusual behaviour. When doctors examined him, he was unable to perform simple tasks or follow commands.

The man, whose story was shared in BMJ Case Reports to raise awareness of a rare cocaine-induced brain disease, was treated for a possible central nervous system infection.

But his condition spiralled quickly out of control when he became withdrawn, uncommunicative and eventually catatonic, with frequent MRI scans showing worsening changes in his brain.

The man’s parents, who took him to hospital, told doctors their son had last taken cocaine two to three days before showing up at A&E.

The man was treated in intensive care for inflammatory leucoencephalopathy – a disease of the white matter of the brain, which can cause significant disability. You can see the level of inflammation in the images above.

The disease affects the nerves that link various parts of the brain to each other and to the spinal cord. It can cause symptoms such as altered levels of consciousness, confusion, impaired language, altered vision, fever or immobility.

Prognosis is poor – the condition progresses rapidly and often leads to death. But miraculously, after two weeks of intensive treatment, the man began to show signs of improvement.

Eventually he was transferred to a rehabilitation hospital and a year after turning up at hospital, his brain scans revealed function was greatly improved. The man claimed he hasn’t touched drugs for a year. 

By sharing his story, doctors hope it will raise awareness of this condition, which they say was ultimately caused by drug use.