A nineteen year-old girl developed rhabdomyolysis and central pyrexia after the ingestion of multiple drugs: amphetamines, benzodiazepines, methadone, ethanol, and cocaine. On admission, the patient was deeply comatose and during the hospitalisation asymmetrical spastic quadriparesis was noted. Brain biopsy was diagnostic of spongiform leucoencephalopathy. A review of the literature concerning drug-induced spongiform encephalopathy revealed a large amount of heroin-induced cases. The role of cocaine, however, is less well described. After prolonged hospitalisation, our patient improved clinically and radiologically and could be transferred to a rehabilitation center.