title: MRI brain findings in ephedrone encephalopathy associated with manganese abuse: Single-center perspective.
abstract: BACKGROUND
  Manganese (Mn) is a well-known toxic agent causing symptoms of parkinsonism in employees of certain branches of industry. Home production of a psychostimulant ephedrone (methcathinone), involving the use of potassium permanganate, became a new cause of intoxications in Poland.
  
  
  METHODS
  This article presents clinical symptoms, initial brain MRI findings and characteristics of changes observed in follow-up examinations in 4 patients with manganese intoxication associated with intravenous administration of ephedrone. All patients in our case series presented symptoms of parkinsonism. T1-WI MRI revealed high intensity signal in globi pallidi in all patients; hyperintense lesions in midbrain were observed in three patients, while lesions located in cerebellar hemispheres and pituitary gland in just one patient. The reduction of signal intensity in the affected brain structures was observed in follow-up studies, with no significant improvement in clinical symptoms.
  
  
  CONCLUSIONS
  Brain MRI is helpful in the assessment of distribution as well as dynamics of changes in ephedrone encephalopathy. Regression of signal intensity changes visible in brain MRI is not associated with clinical condition improvement. Although brain MRI findings are not characteristic for ephedrone encephalopathy, they may contribute to diagnosing this condition.
authors: Department of Radiology, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors: Renata
authors: R
authors: Poniatowska
authors: Department of Radiology, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors: Małgorzata
authors: M
authors: Lusawa
authors: Department of Radiology, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors: Agnieszka
authors: A
authors: Skierczyńska
authors: Department of Radiology, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors: Grzegorz
authors: G
authors: Makowicz
authors: Department of Prevention and Treatment of Addictions, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors: Bogusław
authors: B
authors: Habrat
authors: 1 Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors: Halina
authors: H
authors: Sienkiewicz-Jarosz
keywords: Brain Diseases; Manganese Compounds; Metabolic - ultrasonography