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Neurology Clinical Practice
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Author Response: Amnestic Syndrome and Bilateral Hippocampal Diffusion Abnormalities From Opioid Use

  • Brandon B Holmes, Neurology PGY-4, University of California San Francisco
  • Chris Ahlbach, Medical Student, University of California San Francisco
  • Jared Narvid, Radiologist, University of California San Francisco
  • Nicole Rosendale, 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

  1. 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
  2. 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

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Neurology: Clinical Practice: 13 (1)

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Neurology: Clinical Practice |  Print ISSN: 2163-0402
Online ISSN: 2163-0933

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