Amnestic Syndrome and Bilateral Hippocampal Diffusion Abnormalities From Opioid Use
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Abstract
A 17 year-old man presented to the emergency department unconscious and developed anterograde amnesia without other deficits in mental status, motor function, or coordination. High-resolution mass spectrometry (but not routine immunoassays) of his urine detected the presence of fentanyl, morphine, and oxycodone. A brain MRI showed symmetric reduced diffusion in the bilateral hippocampi and globi pallidi as well as a focus of reduced diffusion in the left cerebellum (Figure 1). His anterograde amnesia gradually improved over 8 days. This case highlights the MR features of opioid-related amnestic syndrome and suggests a critical role for both brain MRI and mass spectrometry-based toxicology screening.1, 2
- Received September 3, 2020.
- Accepted January 7, 2021.
- © 2021 American Academy of Neurology
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The Nerve!: Rapid online correspondence
- Reader response: Amnestic Syndrome and Bilateral Hippocampal Diffusion Abnormalities From Opioid Use
- Jason Randhawa, Neurology PGY-5, St. Paul's Hospital
- Tychicus Chen, Neurologist, University of British Columbia
Submitted January 31, 2021
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