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Practice

Opioid-associated amnestic syndrome observed with fentanyl patch use

Ryan G. Taylor, Adrian Budhram, Donald H. Lee and Seyed M. Mirsattari
CMAJ March 25, 2019 191 (12) E337-E339; DOI: https://doi.org/10.1503/cmaj.181291
Ryan G. Taylor
Department of Clinical Neurological Sciences (Taylor, Budhram, Lee, Mirsattari), and Division of Radiology (Lee), Western University, London, Ont.
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Adrian Budhram
Department of Clinical Neurological Sciences (Taylor, Budhram, Lee, Mirsattari), and Division of Radiology (Lee), Western University, London, Ont.
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Donald H. Lee
Department of Clinical Neurological Sciences (Taylor, Budhram, Lee, Mirsattari), and Division of Radiology (Lee), Western University, London, Ont.
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Seyed M. Mirsattari
Department of Clinical Neurological Sciences (Taylor, Budhram, Lee, Mirsattari), and Division of Radiology (Lee), Western University, London, Ont.
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    Figure 1:

    Journaling as written by a 63-year-old woman with opioid-associated amnestic syndrome. A page from her notepad shows meticulous journaling of daily events and suggests the patient had insight into her amnestic syndrome. Afterward, she had no recollection of these documented events or her journaling of them.

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    Figure 2:

    Serial magnetic resonance imaging (MRI) in opioid-associated amnestic syndrome. Gadolinium-enhanced MRI on day 7 shows bilateral gyriform hippocampal apparent diffusion coefficient hypointensity (A) with corresponding hyperintensity on diffusion-weighted imaging (B), indicating restricted hippocampal diffusivity (white arrows). Hippocampal T2 hyperintensity (C; yellow arrows) along with subtle hippocampal gadolinium enhancement (D; red arrows) is also seen. Follow-up MRI on day 12 (performed without gadolinium despite request) shows resolution of hippocampal restricted diffusion (E) and resolution of T2 hyperintensity (F).

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Canadian Medical Association Journal: 191 (12)
CMAJ
Vol. 191, Issue 12
25 Mar 2019
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Opioid-associated amnestic syndrome observed with fentanyl patch use
Ryan G. Taylor, Adrian Budhram, Donald H. Lee, Seyed M. Mirsattari
CMAJ Mar 2019, 191 (12) E337-E339; DOI: 10.1503/cmaj.181291

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Opioid-associated amnestic syndrome observed with fentanyl patch use
Ryan G. Taylor, Adrian Budhram, Donald H. Lee, Seyed M. Mirsattari
CMAJ Mar 2019, 191 (12) E337-E339; DOI: 10.1503/cmaj.181291
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