Cytotoxic lesion of the corpus callosum after gamma hydroxybutyrate withdrawal: a case report

BACKGROUND: Gamma-hydroxybutyrate (GHB) is frequently misused for its sedative and euphoric effects. Abrupt cessation may result in severe withdrawal; however, neuroimaging correlates of withdrawal-related neurotoxicity remain poorly defined. CASE PRESENTATION: A 33-year-old male developed acute delirium, visual hallucinations, and autonomic instability after abruptly discontinuing frequent and high-dose GHB use. Routine toxicology screening was negative. Brain MRI revealed a focal splenial cytotoxic lesion of the corpus callosum (CLOCCs). He was clinically diagnosed with sedative, hypnotic, or anxiolytic withdrawal; sedative-, hypnotic-, or anxiolytic-induced anxiety disorder; and sedative, hypnotic, or anxiolytic use disorder, severe. His symptoms rapidly resolved with supportive care, and he was discharged without neurological sequelae. CONCLUSION: CLOCCs may represent an important radiological indicator of GHB withdrawal-related neurotoxicity.