Long lasting impaired cerebral blood flow after ecstasy intoxication.
Four hours after having taken 10 ecstasy tablets a Grand Mal seizure occurred in a 19-year-old woman followed by coma, hyperthermia, tachycardia, tachypnea, and renal failure. After awakening she was oriented but presented with helplessness, disconcertion, hallucinations, panic attacks, and amnesic syndrome. Computed tomography and magnetic resonance imaging scans of the brain were normal. [99Tc]-hexamethylpropyleneamine oxime (HMPAO)-single photon emission computed tomography (SPECT), 20 days after intoxication, showed reduced, inhomogeneous, supratentorial tracer uptake bilaterally. Electroencephalography (EEG) disclosed diffuse slowing and occasionally generalized sharp waves. Valproic acid was begun. Except for slight amnesia, neuropsychological deficits had disappeared and [99Tc]-HMPAO-SPECT normalized, 29 days later. Decreased cortical blood flow was explained by vasoconstriction following ecstasy-induced depletion of serotonin.
Finsterer
Josef
J
Neurological Department, KA Ruddfstiftung, Vienna, Austria. duarte@jet2web.cc
Stöllberger
Claudia
C
Steger
Christine
C
Kroiss
Alois
A
D000328:Adult; D002545:Brain Ischemia / Q000139:chemically induced* / Q000000981:diagnostic imaging; D002540:Cerebral Cortex / Q000098:blood supply*; D003128:Coma / Q000139:chemically induced* / Q000000981:diagnostic imaging; D004292:Dominance, Cerebral / Q000502:physiology; D062787:Drug Overdose / Q000000981:diagnostic imaging*; D004569:Electroencephalography / Q000187:drug effects; D004830:Epilepsy, Tonic-Clonic / Q000139:chemically induced* / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000506:poisoning*; D009483:Neuropsychological Tests; D012039:Regional Blood Flow / Q000187:drug effects; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D014661:Vasoconstriction / Q000187:drug effects
D019690:Technetium Tc 99m Exametazime; D018817:N-Methyl-3,4-methylenedioxyamphetamine