Manganese toxicity with ephedrone abuse manifesting as parkinsonism: a case report.
Manganese toxicity with ephedrone abuse manifesting as parkinsonism: a case report.
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DOI：
10.1186/1752-1947-6-52
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发表时间：
2012-02-07
影响因子：
1
通讯作者：
Redmond J
中科院分区：
文献类型：
--
作者：
Iqbal M;Monaghan T;Redmond J
自1837年以来，锰中毒的神经系统后果已被认识到。据报告，东欧和波罗的海国家的吸毒成瘾者静脉注射了自制的甲卡西酮盐酸盐（甲卡西酮）后，出现了一种新的推定锰中毒形式，甲卡西酮是使用高锰酸钾作为强效氧化剂，由盐酸伪麻黄碱合成的。这种临床综合征在西欧认识不足，在爱尔兰的文献中没有报告病例。我们报告一个30岁的东欧男子谁提出了两年的历史步态障碍。神经系统评估显示帕金森综合征的特征，包括发音减退、拟声障碍、轻度运动迟缓和强直，无静息性震颤。走路时，他的手臂略微外展，手臂摆动减少。他的脑部磁共振成像显示苍白球T1高信号，血清锰水平升高。他对左旋多巴没有反应。近年来，由于大规模移民，锰中毒继发于导致帕金森症的马诺酮滥用，在西欧出现，而且往往没有被认识到。本文强调了这种罕见的帕金森综合征的原因，并在其识别和随后的诊断艾滋病的各种特点。西欧的神经科医生将越来越多地遇到这样的病人。
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. 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. 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.