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Leukoencephalopathy associated with khat misuse
  1. P K MORRISH,
  2. N NICOLAOU,
  3. P BRAKKENBERG,
  4. P E M SMITH
  1. Department of Neurology, University Hospital of Wales, Heath Park, Cardiff CF4 4XN, UK
  1. Dr PK Morrish, Department of Neurology, University Hospital of Wales, Heath Park, Cardiff CF4 4XN, UK. Telephone 0044 1222 747747; fax 004 1222 744166; email:morrishpk{at}cardiff.ac.uk

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The leaves of the tree Catha edulis, or khat (also qat and kat) are chewed by a large proportion of the adult population of the Yemen, and throughout Saharan and sub-Saharan Africa. The leaves are also chewed by members of the Yemeni and Somali community in the United Kingdom.1 The psychoactive constituents of khat are cathin (d-norisoephedrine), cathidine, and cathinone (an alkaloid with a structure resembling ephedrine and amphetamine) and users report a mild euphoria similar to that of amphetamine.1 Khat is acknowledged as a precipitant of psychosis and has also been reported to cause cognitive impairment.2 We report a case in which khat chewing has been associated with a severe and disabling neurological illness.

A 56 year old Somali living in the United Kingdom for the past 18 years was admitted to a psychiatric hospital with a 5 week history of progressive confusion and agitation. His family reported that he had been chewing …

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