Manganic encephalopathy due to "ephedrone" abuse.
We describe the clinical and neuroimaging features of 6 drug-abuse patients with self-inflicted manganese poisoning. The patients injected a home-brewed mixture called "ephedrone" (slang term) that contained manganese to produce an amphetamine-like euphoria. The desired chemical product, phenylpropanoneamine (also called methcathinone), was synthesized from a common-cold-remedy compound using permanganate as the catalyst. Manganese was a by-product in the ephedrone mixture. After months of self-injections, a clinical picture emerged, consisting of apathy, bradykinesia, gait disorder with postural instability, and spastic-hypokinetic dysarthria. There was no response to levodopa. The MRI revealed symmetric hyperintense T1-weighted signals in the basal ganglia, typical of manganese accumulation.
Sanotsky
Yanush
Y
Department of Neurology, Lviv Regional Clinical Hospital, Lviv, Ukraine. janush_s@yahoo.com
Lesyk
Roman
R
Fedoryshyn
Lyudmyla
L
Komnatska
Iryna
I
Matviyenko
Yuriy
Y
Fahn
Stanley
S
D000328:Adult; D001479:Basal Ganglia / Q000473:pathology; D001927:Brain Diseases / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020149:Manganese Poisoning / Q000150:complications*; D008875:Middle Aged; D011427:Propiophenones / Q000009:adverse effects*; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000150:complications* / Q000209:etiology*
D011427:Propiophenones; C047806:monomethylpropion