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Spatt J, Glawar B, Mamoli B. 
“A pure amnestic syndrome after MDMA ('ecstasy') ingestion”. 
J Neurol Neurosurg Psychiatry. 1997 Apr;62(4):418-9.
Abstract
We present the data from a 26 year old woman who developed a pure amnestic syndrome after exposure to MDMA. Other than MDMA the patient had taken no other drugs during the months before onset of her symptoms. In the past she had had occasionally taken cocaine and heroin, but she had stopped heroin misuse one year and cocaine some months before onset. She did well at night school, worked part time in an office, and her organic and psychological state was inconspicuous according to her and her parents reports. There was no indication of an unusual nutritive behaviour. Her own and her family s histories were unremarkable concerning seizures and psychiatric diseases. Three days after having taken half a tablet of ecstasy while taking part in a rave , she was brought to an emergency ward in a fearful state, which was interpreted as an MDMA induced psychotic episode. Her mother reported that the episode had started with loss of consciousness and as far as she could remember clonic movements of her arms and legs. Afterwards the patient was disoriented in time and place, and showed regressive infantile behaviour and fear. Routine blood examinations, in particular serum sodium, done immediately after admission, were normal. Blood and urine concentrations of drugs three days after onset were negative, as were the results of EEG, ECG, CT, and HMPAOSPECT. Neuroleptic treatment with clozapine was started. The psychotic episode soon resolved and neuroleptic therapy could be tapered but the patient complained about ongoing memory problems, which led to her admission to our department two months after the acute event. As well as these anterograde memory problems and a retrograde amnesia for about a week she showed normal behaviour and the neurological examination disclosed normal results. In neuropsychological testing she showed an IQ of 109 (WAIS) that was supposed to be somewhat lower than her pre-morbid level, although it was in the normal range. Results of tests of language function and semantic memory (token test: 0 errors, Boston naming test: 82 out of 85), visuospatial abilities (copy of the Rey figure: 36/36), and frontal functions (phonetic fluency: 19 words beginning with s in two minutes, semantic fluency: 26 animals in two minutes) were all within the normal range. Memory function as assessed by a German version of the Warrington recognition memory test yielded results below the 5th percentile for words (37/50) and faces (36/50). Recall of the Rey figure (7*5/36) and the results of a list learning task (10/15 after five learning trials) were also highly impaired. The patient therefore had a rather pure non-material specific disorder of episodic memory. After nine months formal testing showed only a slight improvement in her memory performance. She is still not able to return to night school or her part time job, but she has learned to make extensive use of a diary and a timetable. She had occupational therapy in an outpatient clinic for several months.
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