Anterograde amnesia and hippocampal lesions: is fentanyl the culprit?

Hippocampus (wikipedia.org) 3 out of 5 stars An Unusual Amnesic Syndrome Associated With Combined Fentanyl and Cocaine Use. Duru LB et al. Ann Intern Med 30 Jan 2018 [Epub ahead of print] Reference Last year we reviewed an MMWR report describing 14 cases of anterograde amnesia associated with substance abuse and bilateral ischemia of the hippocampi, as well as an additional paper giving somewhat more detailed clinical information on the initial four cases. This letter describes an additional case that occurred in West Virginia. A 30-year-old man with a history of heroin use was found at home to be difficult to arouse. When he came to his mental status was abnormal and he seemed to be asking the same questions repeatedly. At hospital, serum and urine drug screens were positive for cocaine but negative for opiates. CT head showed “bilateral, symmetrical hypodensities in the hippocampus and basal ganglia.” He was diagnosed with anterograde amnesia. Diffusion-weighted MRI imaging showed hyperintensities in the regions of the hippocampi, fornices, mammilary bodies, and globus pallidus. A urine sample apparently obtained several days after admission was negative for fentanyl but positive for one of its metabolites (norfentanyl.)The remainder of the drug screen was negative (although it is not clear how extensive the tests were.) In their discussion, the authors cite another somewhat similar case from Virginia. They note that although the syndrome of amnesia and hippoc...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical cocaine fentanyl hippocampus hippocampus ischemia norfentanyl opiate opioid Source Type: news