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Methamphetamine-induced Encephalopathy in the Absence of Hyperammonemia

Overview
Journal BMC Psychiatry
Publisher Biomed Central
Specialty Psychiatry
Date 2023 Apr 20
PMID 37081388
Authors
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Abstract

Background: Methamphetamine is an addictive drug with various effects on the neurotransmitters in the central nervous system. Methamphetamine-induced encephalopathy in the absence of hyperammonemia presents a unique challenge in a clinical setting. Previously published cases of methamphetamine-induced encephalopathy suggested that methamphetamine-induced hepatotoxicity and subsequent hyperammonemia may be the cause of encephalopathy. However, the literature is limited on methamphetamine-induced encephalopathy without hyperammonemia.

Case: This case presents a disoriented patient with methamphetamine use disorder in acute toxicity, unable to ambulate independently, and poorly responsive to verbal stimuli. The patient was found to have normal ammonia levels.

Discussion: This patient's presentation and laboratory findings, namely normal ammonia levels, suggest a different pathophysiological pathway for methamphetamine-induced encephalopathy. One potential pathway is through the direct action of methamphetamine on the central nervous system through acute disruption of neurotransmitter signaling and disruption of the blood-brain barrier.

Conclusion: Further research should be conducted into the prevalence and pathophysiology of methamphetamine-induced encephalopathy in the absence of hyperammonemia.

Key Points: Methamphetamine-induced encephalopathy (MIE) in the absence of hyperammonemia presents a unique challenge in a clinical setting. Previously published cases of MIE suggest that methamphetamine-induced hepatotoxicity and subsequent hyperammonemia may be the cause of encephalopathy. Further research should be conducted into the prevalence and pathophysiology of MIE in the absence of hyperammonemia.

References
1.
Canedo T, Portugal C, Socodato R, Almeida T, Terceiro A, Bravo J . Astrocyte-derived TNF and glutamate critically modulate microglia activation by methamphetamine. Neuropsychopharmacology. 2021; 46(13):2358-2370. PMC: 8581027. DOI: 10.1038/s41386-021-01139-7. View

2.
Mader Jr E, Ramos A, Cruz R, Branch L . Full Recovery From Cocaine-Induced Toxic Leukoencephalopathy: Emphasizing the Role of Neuroinflammation and Brain Edema. J Investig Med High Impact Case Rep. 2019; 7:2324709619868266. PMC: 6696843. DOI: 10.1177/2324709619868266. View

3.
Richards J, Farias V, Clingan C . Association of leukocytosis with amphetamine and cocaine use. ScientificWorldJournal. 2014; 2014:207651. PMC: 3919105. DOI: 10.1155/2014/207651. View

4.
Sariaslani P, Ghanbari A, Ghanbari P . Multifocal inflammatory leukoencephalopathy induced by accidental consumption of levamisole: A case report. Iran J Neurol. 2013; 11(2):65-9. PMC: 3829248. View

5.
Weissenborn K . Hepatic Encephalopathy: Definition, Clinical Grading and Diagnostic Principles. Drugs. 2019; 79(Suppl 1):5-9. PMC: 6416238. DOI: 10.1007/s40265-018-1018-z. View