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Published on: November 14, 2012
Cerebral vasculopathy after 4-bromo-2,5-dimethoxyphenethylamine ingestion
Josiah B Ambrose1, Heather D Bennett, Han S Lee
1Department of Neurology, University of California,San Francisco, 505 Parnassus Ave., M798, San Francisco, CA 94143, USA. Josiah.ambrose@ucsf.edu
Background:
4-bromo-2,5-dimethoxyphenethylamine (2C-B) is a designer-drug variant of 3,4-methylenedioxymethamphetamine (ecstasy) whose recreational use has increased significantly over the last 10 years. Neurologic consequences of 2C-B usage are currently unknown.
Case Report:
A 43-year-old woman experienced severe headaches within 48 hours of taking liquid 2C-B, after which time she developed progressive encephalopathy and quadraparesis, which did not improve over several months. MRA and cerebral angiogram imaging demonstrated profound vascular abnormalities of large, medium, and small-caliber vessels with subsequent watershed infarction. Brain biopsy and cerebrospinal fluid studies ruled out an inflammatory process.
Conclusions:
This case demonstrates an idiosyncratic and devastating neurologic response to 2C-B, a recreational drug whose popularity has increased with widespread availability of online guides for its synthesis.
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