Acute Hippocampal Encephalopathy in Heavy Cannabis Users: About 2 Cases - 23/07/20

Doi : 10.1016/j.amjmed.2019.11.018

Quang Tuan Rémy Nguyen, MD ^a,^b,^c,^d, Alban Gravier, MD ^a, Constance Lesoil, MD ^a, Alexandre Bedet, MD ^e, Camille Petit-Hoang, MD ^a, Matthieu Mahevas, MD ^f, Armand Mekontso-Dessap, MD, PhD ^d,^e, Jérôme Hodel, MD, PhD ^a,^d, Anne-Catherine Bachoud-Lévi, MD, PhD ^a,^b,^c,^d, Laurent Cleret de Langavant, MD, PhD ^a,^b,^c,^d,^g,^⁎
^a Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, service de Neurologie, Créteil, France
^b INSERM U955 Equipe E01, Institut Mondor de recherche biomédicale, Neuropsychologie Interventionnelle, Créteil, France
^c Département d'Etudes Cognitives, Ecole Normale Supérieure, PSL University, Paris, France
^d Université Paris Est, Faculté de Médecine, Créteil, France
^e Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, service de Médecine Intensive Réanimation, Créteil, France
^f Assistance Publique-Hôpitaux de Paris, CHU Henri Mondor, service de Médecine interne, Créteil, France
^g Global Brain Health Institute, UCSF, San Francisco, California, USA

^⁎Requests for reprints should be addressed to Laurent Cleret de Langavant, MD, PhD, Service de Neurologie, CHU Henri Mondor, Créteil, F-94010 France.Service de NeurologieCHU Henri MondorCréteilF-94010France

Abstract

Background

Cannabis use is increasing worldwide despite the various health effects of this substance.

Methods

We report 2 cases of acute hippocampal encephalopathy in heavy cannabis users (>10 joints/d).

Results

In both male patients, acute encephalitis was suspected. Brain magnetic resonance imaging (MRI) diffusion-weighted sequences showed bilateral high signal abnormalities in hippocampal regions. Patients had renal dysfunction, rhabdomyolysis, and inflammatory syndrome. Investigations showed no evidence of infectious or autoimmune encephalitides. Repeated electroencephalograms revealed no epileptic activity. Clinical, biological, and magnetic resonance imaging acute abnormalities improved within weeks. New exposure to cannabis yielded a new episode of encephalopathy. In both patients, severe long-lasting episodic memory impairment associated with hippocampal atrophy were observed several months later.

Conclusions

Health professionals should be aware of this cannabis-related syndrome given its severe and long-lasting effects.

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Keywords : Addiction, Cannabis, Encephalopathy, Hippocampus, Memory

Plan

	Funding: Agence Nationale de la Recherche.
	Conflicts of Interest: LCL and ACBL are supported by ANR-17-EURE-0017. QTRN, AG, CL, AB, CP-H, MM, AM-D, JH report none.
	Authorship: All authors had access to the data and a role in writing this manuscript.

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Vol 133 - N° 7

P. e360-e364 - juillet 2020 Retour au numéro

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Acute Hippocampal Encephalopathy in Heavy Cannabis Users: About 2 Cases - 23/07/20

Abstract

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