Methylenedioxymethamphetamine (MDMA)-induced toxic leukoencephalopathy: a case report

Figures & data

Figure 1. Magnetic resonance imaging of the brain showing diffuse white matter changes. (a) T2-weighted diffuse hyper-intensity involving the midbrain, insula, and basal ganglia bilaterally. (b) Bilateral symmetric reduced diffusion in periventricular white matter as seen on diffusion-weighted imaging (DWI). (c,d) FLAIR extent was graded severe.

Table 1. Reported cases in literature of Ecstasy-induced leukoencephalopathy.

Reference	Number of cases	Sex, age	Presentation	Previous diagnosis	Prognosis
Bertram et al. [13]	1	Male, 19	Unconsciousness, unresponsiveness and focal neurological deficits	Drug toxicity	Vegetative state
Aiciati et al. [14]	3	Males, 22, 21, 21	Delirium, paranoia auditory/visual hallucinations, agitation, and memory problems	Drug toxicity	Full recovery
Sacks et al. [15]	1	Male, 26	Unconsciousness, unresponsiveness and focal neurological deficits	Encephalitis	Patient died
Narang et al. [16]	1	Male, 22	Unconsciousness and unresponsiveness	Menigio-encephalitis	Full recovery
Ginat [17]	1	Male, 17	Headache, altered mental status, and double vision	None	Not mentioned

Bertram M, Egelhoff T, Schwarz S, et al. Toxic leukencephalopathy following “ecstasy” ingestion. J Neurol. 1999 Jul;246(7):617–618. doi: 10.1007/s004150050416

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Alciati A, Scaramelli B, Fusi A, et al. Three cases of delirium after “ecstasy” ingestion. J Psychoactive Drugs. 1999;31(2):167–170. doi: 10.1080/02791072.1999.10471740

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Sacks J, Ray MJ, Williams S, et al. Fatal toxic leukoencephalopathy secondary to overdose of a new psychoactive designer drug 2C-E (“Europa”). Proc (Bayl Univ Med Cent). 2012;25(4):374–376. doi: 10.1080/08998280.2012.11928883

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Narang RK, Jadun CK, Carr B. A case of MDMA toxicity with unusual clinical and neuroradiological features 2CO1. J Intensive Care Soc. 2014;15(1):70–73. doi: 10.1177/175114371401500116

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Ginat DT. MRI of toxic leukoencephalopathy syndrome associated with methylenedioxymethamphetamine. Neurology. 2015;17;84(7):757. doi: 10.1212/WNL.0000000000001271

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