Author Response: Amnestic Syndrome and Bilateral Hippocampal Diffusion Abnormalities From Opioid Use
Brandon BHolmes, Neurology PGY-4, University of California San Francisco
ChrisAhlbach, Medical Student, University of California San Francisco
JaredNarvid, Radiologist, University of California San Francisco
NicoleRosendale, Neurologist, University of California San Francisco
Submitted April 28, 2021
We thank Drs. Randhawa and Chen for their comments on our article.1 We appreciate their insightful comments regarding the possibility of delayed leukoencephalopathy in patients with acute opioid-associated amnestic syndrome.2 Our patient1 did indeed have interval follow-up at one, three, and thirty-four months after the index hospitalization. By one month, the patient returned to his prior cognitive baseline with no reported memory deficits. Since his hospitalization, he has not experienced any new neurologic symptoms including headaches, vision changes, weakness, sensory changes, tremor, bradykinesia, or gait changes. No further brain imaging was indicated. We strongly agree that patients with opioid-associated amnestic syndrome warrant close follow-up given the possibility of unforeseen neurologic sequalae. Going forward, it will be important to understand the risk factors predisposing to opioid-associated delayed leukoencephalopathy as well as the latent period range after opioid exposure.
Disclosure
The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.
References
Ahlbach C, Holmes B, Narvid J, Rosendale N. Amnestic Syndrome and Bilateral Hippocampal Diffusion Abnormalities From Opioid Use. Neurol Clin Pract. Jan 2021, doi: 10.1212/CPJ.0000000000001056
Switzer AR, Beland B, Sarna JR, Walzak A, Pfeffer G. Fentanyl Overdose Causing Hippocampal Ischaemia Followed by Delayed Leukoencephalopathy. Can J Neurol Sci. 2020;47(3):398-399. doi:10.1017/cjn.2020.33
We thank Drs. Randhawa and Chen for their comments on our article.1 We appreciate their insightful comments regarding the possibility of delayed leukoencephalopathy in patients with acute opioid-associated amnestic syndrome.2 Our patient1 did indeed have interval follow-up at one, three, and thirty-four months after the index hospitalization. By one month, the patient returned to his prior cognitive baseline with no reported memory deficits. Since his hospitalization, he has not experienced any new neurologic symptoms including headaches, vision changes, weakness, sensory changes, tremor, bradykinesia, or gait changes. No further brain imaging was indicated. We strongly agree that patients with opioid-associated amnestic syndrome warrant close follow-up given the possibility of unforeseen neurologic sequalae. Going forward, it will be important to understand the risk factors predisposing to opioid-associated delayed leukoencephalopathy as well as the latent period range after opioid exposure.
Disclosure
The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.
References