Cerebral vasculopathy after 4-bromo-2,5-dimethoxyphenethylamine ingestion

Neurologist. 2010 May;16(3):199-202. doi: 10.1097/NRL.0b013e3181a3cb53.

Abstract

Background: 4-bromo-2,5-dimethoxyphenethylamine (2C-B) is a designer-drug variant of 3,4-methylenedioxymethamphetamine (ecstasy) whose recreational use has increased significantly over the last 10 years. Neurologic consequences of 2C-B usage are currently unknown.

Case report: A 43-year-old woman experienced severe headaches within 48 hours of taking liquid 2C-B, after which time she developed progressive encephalopathy and quadraparesis, which did not improve over several months. MRA and cerebral angiogram imaging demonstrated profound vascular abnormalities of large, medium, and small-caliber vessels with subsequent watershed infarction. Brain biopsy and cerebrospinal fluid studies ruled out an inflammatory process.

Conclusions: This case demonstrates an idiosyncratic and devastating neurologic response to 2C-B, a recreational drug whose popularity has increased with widespread availability of online guides for its synthesis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Brain Infarction / chemically induced*
  • Brain Infarction / pathology
  • Brain Infarction / physiopathology
  • Cerebral Angiography
  • Cerebral Arteries / diagnostic imaging
  • Cerebral Arteries / drug effects*
  • Cerebral Arteries / pathology
  • Cocaine / adverse effects
  • Cognition Disorders / chemically induced
  • Cognition Disorders / pathology
  • Cognition Disorders / physiopathology
  • Dimethoxyphenylethylamine / adverse effects
  • Dimethoxyphenylethylamine / analogs & derivatives*
  • Drug Interactions / physiology
  • Female
  • Hallucinogens / adverse effects*
  • Headache / chemically induced
  • Humans
  • Magnetic Resonance Imaging
  • Marijuana Smoking / adverse effects
  • Persistent Vegetative State / chemically induced
  • Persistent Vegetative State / pathology
  • Persistent Vegetative State / physiopathology
  • Quadriplegia / etiology
  • Risk Factors
  • Time
  • Vasospasm, Intracranial / chemically induced*
  • Vasospasm, Intracranial / diagnostic imaging
  • Vasospasm, Intracranial / pathology

Substances

  • Dimethoxyphenylethylamine
  • Hallucinogens
  • Cocaine
  • 2-(4-bromo-2,5-dimethoxyphenyl)ethylamine