Castillo Austin, Payne J Drew, Nugent Kenneth
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.
Proc (Bayl Univ Med Cent). 2017 Jul;30(3):355-357. doi: 10.1080/08998280.2017.11929647.
Posterior reversible encephalopathy syndrome has been associated with hypertension, preeclampsia, cancer chemotherapy, and drugs of abuse, such as amphetamine and methamphetamine. We report a young man who suddenly developed severe headache, disorientation, and aphasia following ingestion of kratom and Adderall. Computed tomography and magnetic resonance imaging of his head revealed foci of vasogenic edema in the posterior occipital lobes, frontal lobes, and brainstem. In addition, he had a small area of hemorrhage in the left posterior occipital lobe. Lumbar puncture revealed an increased number of red blood cells but no other abnormalities. His initial blood pressure was elevated but returned to normal during hospitalization. This case suggests that kratom can cause posterior reversible encephalopathy syndrome and needs to be considered when patients present to emergency centers with headaches, confusion, and visual disturbances.
后部可逆性脑病综合征与高血压、先兆子痫、癌症化疗以及滥用药物（如苯丙胺和甲基苯丙胺）有关。我们报告了一名年轻男子，他在服用 kratom 和阿得拉后突然出现严重头痛、定向障碍和失语。他的头部计算机断层扫描和磁共振成像显示枕叶后部、额叶和脑干有血管源性水肿灶。此外，他左枕叶后部有一小片出血区。腰椎穿刺显示红细胞数量增加，但无其他异常。他入院时血压升高，但住院期间恢复正常。该病例表明，kratom 可导致后部可逆性脑病综合征，当患者因头痛、意识模糊和视觉障碍到急诊中心就诊时，需要考虑这一因素。
