Cerebral vasculopathy after 4-bromo-2,5-dimethoxyphenethylamine ingestion.
BACKGROUND
4-bromo-2,5-dimethoxyphenethylamine (2C-B) is a designer-drug variant of 3,4-methylenedioxymethamphetamine (ecstasy) whose recreational use has increased significantly over the last 10 years. Neurologic consequences of 2C-B usage are currently unknown.


METHODS
A 43-year-old woman experienced severe headaches within 48 hours of taking liquid 2C-B, after which time she developed progressive encephalopathy and quadraparesis, which did not improve over several months. MRA and cerebral angiogram imaging demonstrated profound vascular abnormalities of large, medium, and small-caliber vessels with subsequent watershed infarction. Brain biopsy and cerebrospinal fluid studies ruled out an inflammatory process.


CONCLUSIONS
This case demonstrates an idiosyncratic and devastating neurologic response to 2C-B, a recreational drug whose popularity has increased with widespread availability of online guides for its synthesis.
Ambrose
Josiah B
JB
Department of Neurology, University of California,San Francisco, 505 Parnassus Ave., M798, San Francisco, CA 94143, USA. Josiah.ambrose@ucsf.edu
Bennett
Heather D
HD
Lee
Han S
HS
Josephson
S Andrew
SA
D000328:Adult; D020520:Brain Infarction / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D003042:Cocaine / Q000009:adverse effects; D003072:Cognition Disorders / Q000139:chemically induced / Q000473:pathology / Q000503:physiopathology; D004118:Dimethoxyphenylethylamine / Q000009:adverse effects / Q000031:analogs & derivatives*; D004347:Drug Interactions / Q000502:physiology; D005260:Female; D006213:Hallucinogens / Q000009:adverse effects*; D006261:Headache / Q000139:chemically induced; D006801:Humans; D008279:Magnetic Resonance Imaging; D008385:Marijuana Smoking / Q000009:adverse effects; D018458:Persistent Vegetative State / Q000139:chemically induced / Q000473:pathology / Q000503:physiopathology; D011782:Quadriplegia / Q000209:etiology; D012307:Risk Factors; D013995:Time; D020301:Vasospasm, Intracranial / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology
D004118:Dimethoxyphenylethylamine; D006213:Hallucinogens; D003042:Cocaine; C079321:2-(4-bromo-2,5-dimethoxyphenyl)ethylamine