Long‐Segment Sciatic Neuropathy After Heroin Overdose

ABSTRACT Non‐traumatic mononeuropathy due to heroin overdose is rare. The exact mechanism is not yet clear. We report a 20‐year‐old male who developed acute onset weakness and paresthesias of the distal part of the right lower limb after heroin overdose. Neurological examination was suggestive of right sciatic neuropathy with allodynia along the course of the nerve. Detailed workup for neuropathy was negative. MR Neurography revealed longitudinal extensive thickening and hyperintensity of the sciatic nerve throughout its course with contiguous involvement of the common peroneal nerve. He gradually improved on symptomatic treatment. This case highlights the importance of using newer diagnostic modalities to understand the known but rare complications of heroin abuse.