Bilateral hippocampal toxicity in a patient using kratom

Area of Science:

• Neuroscience
• Toxicology
• Neurology

Background:

• Kratom (Mitragyna speciosa) is an emerging recreational drug with known adverse effects.
• Central nervous system (CNS) structural changes linked to kratom are infrequently reported.
• Altered mental status and amnesia are significant neurological symptoms requiring investigation.

Purpose of the Study:

• To report a rare case of central nervous system structural changes associated with kratom use.
• To highlight the potential neurotoxic effects of kratom ingestion.
• To emphasize the importance of considering kratom in differential diagnoses for altered mental status.

Main Methods:

• Case report of a young adult male presenting with neurological symptoms.
• Clinical evaluation including laboratory tests (liver function, ammonia levels).
• Magnetic Resonance Imaging (MRI) of the brain to assess structural changes.

Main Results:

• The patient presented with altered mental status, anterograde, and retrograde amnesia following kratom consumption.
• Laboratory results indicated elevated alanine aminotransferase and ammonia levels.
• Brain MRI revealed bilateral hippocampal T2 hyperintensity signal changes, suggesting cytotoxic edema or gliosis.

Conclusions:

• Kratom ingestion can lead to significant neurological deficits and rare structural brain changes.
• Hippocampal T2 hyperintensity is a potential neuroimaging finding in kratom toxicity.
• Clinicians should consider kratom use in patients with unexplained neurological symptoms and altered mental status.