By Marie Yrastorza and Shaan Sharna
Eastern Virginia Medical School
Norfolk, VA
A Case and Differential Diagnosis of Anterograde Amnesia from Bilateral Hippocampal Ischemia due to Opiate Intoxication
Eastern Virginia Medical School students Marie Yrastorza and Shaan Sharma presented a case report on opioid-induced anterograde amnesia at this year’s PSV Fall Conference. The presentation, titled “A Case and Differential Diagnosis of Anterograde Amnesia from Bilateral Hippocampal Ischemia due to Opiate Intoxication”, explored the case of a 57-year-old woman who presented to a Norfolk, Virginia hospital with altered mentation.
The patient had a history of bipolar disorder and substance use and had ingested opioids the night before presentation. The patient was originally found unconscious at home. She demonstrated slurred speech, decreased respiratory rate and psychomotor retardation in the ER. Mentation improved slightly after administration of 0.2 g of naloxone. The patient was oriented to self with a MOCA of 22 on day 1 and demonstrated anterograde amnesia throughout her hospital stay. After 5 days her MOCA improved to 25. Imaging demonstrated symmetrical hippocampal lesions on MRI. The presentation of the patient meets diagnostic criteria for opioid-induced amnestic syndrome, a recently defined condition that requires greater public and clinician awareness.
This case illustrates one of many deleterious effects of the opioid epidemic in the United States and may be connected to the rise in synthetic opioid use.
