Author Response: Amnestic Syndrome and Bilateral Hippocampal Diffusion Abnormalities From Opioid Use

We thank Drs. Randhawa and Chen for their comments on our article.¹ We appreciate their insightful comments regarding the possibility of delayed leukoencephalopathy in patients with acute opioid-associated amnestic syndrome.² Our patient¹ did indeed have interval follow-up at 1, 3, and 34 months after the index hospitalization. By 1 month, the patient returned to his previous cognitive baseline with no reported memory deficits. Since his hospitalization, he has not experienced any new neurologic symptoms, including headaches, vision changes, weakness, sensory changes, tremor, bradykinesia, or gait changes. No further brain imaging was indicated. We agree that patients with opioid-associated amnestic syndrome warrant close follow-up given the possibility of unforeseen neurologic sequelae. Going forward, it will be important to understand the risk factors predisposing to opioid-associated delayed leukoencephalopathy and the latent period range after opioid exposure.