title: Synthetic cannabinoids revealing adrenoleukodystrophy.
abstract: We report a 41-year-old man who presented with a first generalized tonic-clonic seizure after recent consumption of a synthetic cannabinoid. MRI showed extensive bilateral, mainly frontal, white matter lesions. Blood analysis for very long chain fatty acids was compatible with adrenoleukodystrophy, and a missense mutation in the ABCD1 gene confirmed the diagnosis. We hypothesize that cannabinoid use might have contributed to metabolic decompensation with subacute worsening of the underlying condition.
authors.affiliation: Department of Neurology, Rabin Medical Center, Beilinson Hospital, 39 Jabotinski Street, Petah Tikva 49100, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: avi.fellner@gmail.com.
authors.forename: Avi
authors.initials: A
authors.lastname: Fellner
authors.affiliation: Department of Neurology, Rabin Medical Center, Beilinson Hospital, 39 Jabotinski Street, Petah Tikva 49100, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Felix
authors.initials: F
authors.lastname: Benninger
authors.affiliation: Department of Neurology, Rabin Medical Center, Beilinson Hospital, 39 Jabotinski Street, Petah Tikva 49100, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ruth
authors.initials: R
authors.lastname: Djaldetti
mesh_terms: D000074063:ATP Binding Cassette Transporter, Subfamily D, Member 1; D018528:ATP-Binding Cassette Transporters / Q000235:genetics; D000326:Adrenoleukodystrophy / Q000175:diagnosis* / Q000235:genetics; D000328:Adult; D002186:Cannabinoids / Q000009:adverse effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020125:Mutation, Missense; D012640:Seizures / Q000209:etiology
chemical_list: C115572:ABCD1 protein, human; D000074063:ATP Binding Cassette Transporter, Subfamily D, Member 1; D018528:ATP-Binding Cassette Transporters; D002186:Cannabinoids
keywords: Adrenoleukodystrophy; Cannabinoids; Leukodystrophies; MRI; Seizures