Abstract
Heroin-induced leukoencephalopathy (HLE) is a rare disease that can present with a variety of neurological symptoms ranging from mild to severe, including death. This condition is associated with inhaling heroin, a phenomenon well-documented in the literature and termed "chasing the dragon". Here, we discuss a case of a 27-year-old female who presented with subacute neurological symptoms following two years of recreational heroin inhalation. Magnetic resonance imaging (MRI) findings were consistent with diffuse symmetrical corticospinal tract hyperintensities. Herein, we will describe her clinical course with one year of follow-up.