Acute Paralysis Following Recreational MDMA (Ecstasy) Use

Abstract

Methylenedioxymethamphetamine (MDMA), commonly known as Ecstasy, is a hallucinogenic compound structurally related to amphetamine. Ecstasy's severe neurological toxicity includes seizures, subarachnoidal hemorrhage, cerebral infarction, intracranial bleeding and cerebral venous thrombosis. We describe the first case of spinal cord damage presenting as acute quadriplegia and respiratory insufficiency in a healthy adolescent following Ecstasy recreational usage.

Spinal cord injury after the use of ecstasy in a young male

“…Pharmacological treatment of an SCI/D following ingestion of ecstasy has been described by Goldstein et al [13]. MRI images showed a dilating lesion of the spinal cord, with high T2 signals and mild gadolinium enhancement.…”

“…All patients were discharged home with no sequelae. Goldstein et al described the first case of severe spinal cord injury/dysfunction (SCI/D) following the use of ecstasy presenting as an acute quadriplegia and respiratory insufficiency [13]. The patient was admitted to the acute care hospital for 3 months, and afterwards spent 3 months at a rehabilitation center.…”

Rhabdomyolysis Accompanied by Spontaneous Spinal Subdural and Subarachnoid Hematoma Related to Amphetamine Abuse

“…There are 3 possible mechanisms accounting for the presented pathology (1): myoglobinuria associated with acute rhabdomyolysis, (2) direct renal toxicity causing acute interstitial or tubular nephritis, and (3) disseminated intravascular coagulation causing renal vasculopathy. 2,8,10,13 Our patient had hyperkalemia and elevated CPK levels; hence rhabdomyolysis was diagnosed. However, the rhabdomyolysis related to amphetamine abuse may due to prolonged immobility leading to decreased muscle perfusion, coagulopathy, systemic hypotension, and hyperpyrexia.…”

“…The adverse effects of methylene-dioxy-meth-amphetamine are similar to those of amphetamine. 3,10 Limited experience with intracranial hemorrhages related to amphetamine abuse has been reported. Amphetamine or cocaineinduced cerebral hemorrhages are considered to be predisposing factors for hemorrhage due to vasculitis or AVM, more likely to occur with high blood pressure.…”

“…Goldstein reported a case of spinal cord damage with acute quadriplegia and respiratory insufficiency associated with methylene-dioxy-meth-amphetamine usage. 10 Transient acute renal failure was also noted. The adverse effects of methylene-dioxy-meth-amphetamine are similar to those of amphetamine.…”