Reader Response: Amnestic Syndrome and Bilateral Hippocampal Diffusion Abnormalities From Opioid Use
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Reports of opioid-associated amnestic syndrome1 have increased with the rising use of opioids, particularly among young men.2 At our institution in British Columbia, which has one of the highest rates of opioid-related hospitalizations in Canada,3 we have observed at least 3 such cases in the last 4 years with similar initial imaging. All were positive for fentanyl on urine toxicology. One of these was associated with a delayed leukoencephalopathy causing akinetic mutism, which developed roughly 3 weeks after initial presentation with isolated anterograde amnesia. Diffuse delayed leukoencephalopathy was recently reported as an unexpected outcome of acute opioid-associated amnestic syndrome.4 It would be interesting to know the eventual outcome in this case, and if any follow-up was provided. Monitoring for a delayed leukoencephalopathy should be considered by neurologists caring for these vulnerable patients. Prognosis should be deferred until these patients have been stable for at least 1 month after presentation.
Footnotes
Author disclosures are available upon request (ncpjournal{at}neurology.org)
- © 2021 American Academy of Neurology
References
- 1.↵
- Ahlbach C,
- Holmes BB,
- Narvid J,
- Rosendale N
- 2.↵
- Barash JA,
- Whitledge J,
- Watson CJ, et al.
- 3.↵
- 4.↵
- Switzer AR,
- Beland B,
- Sarna JR,
- Walzak A,
- Pfeffer G
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