To our knowledge this is the first report of oral dextroamphetamine sulfate overdose followed by multiple CNS complications, including angiographic evidence of cerebral vasculitis.
REPORT OF A CASE
A 25-year-old man, a known abuser of amphetamines, was admitted in a semicomatose state. He had ingested 50 dextroamphetamine sulfate tablets within the previous 24 hours. His BP was 240/100 mm Hg. He repidly became tachycardic and had a generalized seizure. Therapy was started with phenytoin sodium, phenobarbital sodium, and dexamethasone phosphate for cerebral edema.The next day a four-vessel cerebral angiogram revealed a 2-mm fusiform aneurysm of the left anterior temporal branch of the middle cerebral artery. There were multiple areas of luminal irregularity throughout the supratentorial circulation suggestive of a vasculopathy (Figure). A lumbar puncture yielded hemorrhagic nonclotting CSF, with 1,200 RBCs, a protein level of 70 mg/dL, no WBCs, and a glucose level of 60 mg/dL. He remained obtunded.
Matick H, Anderson D, Brumlik J. Cerebral Vasculitis Associated With Oral Amphetamine Overdose. Arch Neurol. 1983;40(4):253–254. doi:10.1001/archneur.1983.04050040083018
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