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Opioid-associated amnestic syndrome: Description of the syndrome and validation of a proposed definition
Journal of the Neurological Sciences ( IF 3.6 ) Pub Date : 2020-10-01 , DOI: 10.1016/j.jns.2020.117048
Jed A Barash 1 , James Whitledge 2 , C James Watson 2 , Katherine Boyle 2 , Chun Lim 3 , Michael H Lev 4 , Alfred DeMaria 5 , Michael Ganetsky 2
Affiliation  

OBJECTIVE An opioid-associated amnestic syndrome (OAS) characterized by acute onset memory loss and bilateral hippocampal signal abnormalities on brain imaging in the setting of a history of opioid use, most notably fentanyl, has been reported. To date, however, there is no case definition to assist neurologists and other clinicians in identifying this syndrome. A multi-disciplinary collaboration of physicians, including neurologists, propose diagnostic criteria for OAS using cases that have been published in the medical literature or presented at conferences. METHODS Cases were classified as confirmed, probable, or possible based on brain imaging findings and history or analytical testing supporting opioid use. Published articles and presentations were identified by discussion with public health authorities and a systematic search of PubMed. Included were articles, abstracts or posters through November 2019 that presented case reports or case series of a new-onset amnestic syndrome associated with bilateral hippocampal injury on imaging and/or prior opioid or other substance use. The percentages of cases that would meet confirmed, probable, or possible criteria were calculated. RESULTS Twenty-three publications from all sources met criteria for inclusion, accounting for 40 unique cases. Based on the case definition of OAS, 50% (20/40) were confirmed, 25% (10/40) were probable and 25% (10/40) were possible. CONCLUSION The development of a validated, formal case definition for OAS can assist neurologists and other clinicians in evaluating patients with amnesia and a history of opioid use.

中文翻译:

阿片类药物相关遗忘综合征:综合征的描述和拟议定义的验证

目的 一种阿片类药物相关遗忘综合征 (OAS) 的特征是急性发作性记忆丧失和双侧海马信号异常,在阿片类药物使用史的背景下,最显着的是芬太尼。然而,迄今为止,尚无病例定义可帮助神经科医生和其他临床医生识别该综合征。包括神经科医生在内的多学科医生合作,使用已发表在医学文献中或在会议上发表的病例提出 OAS 的诊断标准。方法 根据脑成像结果和支持阿片类药物使用的历史或分析测试,将病例分为确诊、可能或可能。通过与公共卫生当局的讨论和对 PubMed 的系统搜索来确定已发表的文章和演示文稿。包括截至 2019 年 11 月的文章、摘要或海报,这些文章、摘要或海报介绍了与双侧海马损伤相关的影像学和/或先前使用阿片类药物或其他物质的新发遗忘综合征的病例报告或病例系列。计算符合确诊、可能或可能标准的病例百分比。结果 来自所有来源的 23 篇出版物符合纳入标准,占 40 个独特案例。根据 OAS 的病例定义,50% (20/40) 被确认,25% (10/40) 是可能的,25% (10/40) 是可能的。结论 制定有效的、正式的 OAS 病例定义可以帮助神经科医生和其他临床医生评估健忘症和阿片类药物使用史的患者。截至 2019 年 11 月的摘要或海报展示了与双侧海马损伤相关的影像学和/或先前使用阿片类药物或其他物质的新发遗忘综合征的病例报告或病例系列。计算符合确诊、可能或可能标准的病例百分比。结果 来自所有来源的 23 篇出版物符合纳入标准,占 40 个独特案例。根据 OAS 的病例定义,50% (20/40) 被确认,25% (10/40) 是可能的,25% (10/40) 是可能的。结论 制定有效的、正式的 OAS 病例定义可以帮助神经科医生和其他临床医生评估健忘症和阿片类药物使用史的患者。截至 2019 年 11 月的摘要或海报展示了与双侧海马损伤相关的影像学和/或先前使用阿片类药物或其他物质的新发遗忘综合征的病例报告或病例系列。计算符合确诊、可能或可能标准的病例百分比。结果 来自所有来源的 23 篇出版物符合纳入标准,占 40 个独特案例。根据 OAS 的病例定义,50% (20/40) 被确认,25% (10/40) 是可能的,25% (10/40) 是可能的。结论 制定有效的、正式的 OAS 病例定义可以帮助神经科医生和其他临床医生评估健忘症和阿片类药物使用史的患者。
更新日期:2020-10-01
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