Fentanyl Overdose Causing Hippocampal Ischaemia Followed by Delayed Leukoencephalopathy

Switzer, Aaron; Beland, Benjamin; Sarna, Justyna R.; Walzak, Alison; Pfeffer, Gerald

doi:10.1017/cjn.2020.33

Cited by 14 publications

(12 citation statements)

References 10 publications

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“…1 Neuroimaging findings often resolve within days to weeks of the inciting event making diagnosis challenging in this vulnerable population. 1 We report the second case of a diffuse leukoencephalopathy occurring within weeks of confirmed OAS 2 as recently defined by Barash et al 1 In this case, as with many cases of OAS, one cannot rule out the confounding effect of hypoxia as a cause. 3 It is currently unknown how commonly OAS progresses in this manner given the scarcity of reported cases.…”

mentioning

confidence: 65%

Opioid-Associated Amnestic Syndrome Progressing to Diffuse Leukoencephalopathy

Meng

Randhawa

2022

The Neurohospitalist

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mentioning

confidence: 65%

Opioid-Associated Amnestic Syndrome Progressing to Diffuse Leukoencephalopathy

Meng

Randhawa

2022

The Neurohospitalist

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“…Fentanyl overdose fatalities and the opioid crisis are mainly attributable to drug-induced respiratory depression. Fentanyl overdose induces hippocampal ischemia, accompanied by delayed leukoencephalopathy [ 104 ]. Fentanyl but not morphine alters mitochondrial morphology, depending on the dosage and cell type, and this may be associated with neuronal apoptosis [ 105 , 106 ].…”

Section: Pharmacological Interventions To Attenuate Fentanyl-induced ...mentioning

confidence: 99%

Unique Pharmacology, Brain Dysfunction, and Therapeutic Advancements for Fentanyl Misuse and Abuse

et al. 2022

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Fentanyl is a fully synthetic opioid with analgesic and anesthetic properties. It has become a primary driver of the deadliest opioid crisis in the United States and elsewhere, consequently imposing devastating social, economic, and health burdens worldwide. However, the neural mechanisms that underlie the behavioral effects of fentanyl and its analogs are largely unknown, and approaches to prevent fentanyl abuse and fentanyl-related overdose deaths are scarce. This review presents the abuse potential and unique pharmacology of fentanyl and elucidates its potential mechanisms of action, including neural circuit dysfunction and neuroinflammation. We discuss recent progress in the development of pharmacological interventions, anti-fentanyl vaccines, anti-fentanyl/heroin conjugate vaccines, and monoclonal antibodies to attenuate fentanyl-seeking and prevent fentanyl-induced respiratory depression. However, translational studies and clinical trials are still lacking. Considering the present opioid crisis, the development of effective pharmacological and immunological strategies to prevent fentanyl abuse and overdose are urgently needed.

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“…Acute fentanyl intoxication cause spongiform leukoencephalopathy in toddlers ( Foy et al, 2011 ) and adult patients ( Switzer et al, 2020 ). MRI and histological findings showed cerebral hemorrhage ( Helander et al, 2017 ) and cerebral edema ( Freni et al, 2019 ; Geile et al, 2019 ; Guerrieri et al, 2017 ; Schonfeld et al, 2019 ) in the majority of fentanyl and fentanyl-related clinical cases ( Fomin et al, 2018 ).…”

Section: Fentanyl Use Disordermentioning

confidence: 99%

“…MRI and histological findings showed cerebral hemorrhage ( Helander et al, 2017 ) and cerebral edema ( Freni et al, 2019 ; Geile et al, 2019 ; Guerrieri et al, 2017 ; Schonfeld et al, 2019 ) in the majority of fentanyl and fentanyl-related clinical cases ( Fomin et al, 2018 ). Fentanyl users also had hyperintensities in the hippocampus ( Switzer et al, 2020 ). MRI in preterm infants found cerebellar injury and cerebellar hemorrhage that correlated with high dosages of fentanyl ( McPherson et al, 2015 ).…”

Section: Fentanyl Use Disordermentioning

confidence: 99%