Display options
Cite
Iqbal M, Monaghan T, Redmond J. Manganese toxicity with ephedrone abuse manifesting as parkinsonism: a case report. J Med Case Rep. 2012;6:52doi: 10.1186/1752-1947-6-52.
Iqbal, M., Monaghan, T., & Redmond, J. (2012). Manganese toxicity with ephedrone abuse manifesting as parkinsonism: a case report. Journal of medical case reports, 652. https://doi.org/10.1186/1752-1947-6-52
Iqbal, Mudassir, et al. "Manganese toxicity with ephedrone abuse manifesting as parkinsonism: a case report." Journal of medical case reports vol. 6 (2012): 52. doi: https://doi.org/10.1186/1752-1947-6-52
Iqbal M, Monaghan T, Redmond J. Manganese toxicity with ephedrone abuse manifesting as parkinsonism: a case report. J Med Case Rep. 2012 Feb 07;6:52. doi: 10.1186/1752-1947-6-52. PMID: 22313512; PMCID: PMC3292443.
Copy Download .nbib Format: NLM
Share it on

J Med Case Rep. 2012 Feb 07;6:52. doi: 10.1186/1752-1947-6-52.

Manganese toxicity with ephedrone abuse manifesting as parkinsonism: a case report.

Journal of medical case reports

Mudassir Iqbal, Thomas Monaghan, Janice Redmond

Affiliations

  1. Department of Neurology, St James's Hospital, Dublin, Ireland. [email protected].

PMID: 22313512 PMCID: PMC3292443 DOI: 10.1186/1752-1947-6-52

Abstract

INTRODUCTION: Neurologic consequences of manganese toxicity have been recognized since 1837. A new form of presumed manganese poisoning has been reported in drug-addicted persons from Eastern Europe and the Baltic states who have intravenously injected self-prepared methcathinone hydrochloride (ephedrone), which is synthesized from pseudoephedrine hydrochloride using potassium permanganate as a potent oxidant. This clinical syndrome is under-recognized in Western Europe and there are no reported cases in the literature from Ireland.

CASE PRESENTATION: We report a 30-year-old Eastern European man who presented with a two-year history of gait disturbance. A neurological assessment revealed features of parkinsonism which included hypophonia, hypomimia, mild bradykinesia and rigidity with no resting tremor. He held his arms slightly abducted from his sides when walking, with a reduction in arm swing. Magnetic resonance imaging of his brain showed a high signal on T1 in the globus pallidus and serum manganese levels were raised. He had no response to levodopa.

CONCLUSION: Manganism secondary to ephedrone abuse causing parkinsonism has emerged in Western Europe in recent years due to mass immigration and often remains unrecognized. This paper highlights the various features of this rare cause of parkinsonism and aids in its recognition and subsequent diagnosis. Neurologists in Western Europe will increasingly encounter such patients.

References

  1. Neurology. 1996 Feb;46(2):492-8 - PubMed
  2. Neurotoxicology. 1999 Apr-Jun;20(2-3):213-23 - PubMed
  3. Am J Physiol. 1966 Jul;211(1):211-6 - PubMed
  4. Zh Nevrol Psikhiatr Im S S Korsakova. 2005;105(7):12-20 - PubMed
  5. Neurotoxicology. 1981 Jan;2(1):53-64 - PubMed
  6. J Toxicol Clin Toxicol. 1986;24(3):235-44 - PubMed

Publication Types