Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 26006  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded53    
    Comments [Add]    
    Cited by others 12    

Recommend this journal


Year : 2012  |  Volume : 60  |  Issue : 2  |  Page : 224--227

Chronic manganese toxicity due to substance abuse in Turkish patients

Department of Neurology, Bakirköy Research and Training Hospital for Neurologic and Psychiatric Diseases, Istanbul, Turkey

Correspondence Address:
Vedat Sozmen
Department of Neurology, Bakirkoy State Hospital for Neurologic and Psychiatric Diseases, Gelengul Sok. Ar Apt. No: 11 Caddebostan, Kadikoy, Istanbul
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.96407

Rights and Permissions

Background: Manganese toxicity may lead to a levodopa-resistant akinetic-rigid syndrome. Pathological changes occur mostly in the pallidium and stratium. Materials and Methods: We report seven patients with a new form of chronic manganese toxicity due to long-term intravenous use of a solution consisting of ephedrine, acetylsalicylic acid and potassium permanganate as a psycho-stimulant, popularly known as "Russian Cocktail". Results: The age of the patients ranged between 19 and 31 years, and the duration of substance abuse was between nine and 106 months. The onset of symptoms from first use ranged seven to 35 months. The initial symptom was impaired speech followed by gait disturbance and bradykinesia. In addition to these symptoms, choreic movements, ataxia presenting as backward falls and dystonia were also seen. Serum and urine samples revealed high levels of manganese. Hyperintense lesions on T1-weighted magnetic resonance imaging were seen in bilateral basal ganglia and brainstem, dentate nuclei, features consistent with manganese intoxication. Conclusion: Manganese toxicity, which may cause a distinctive irreversible neurodegenerative disorder, can be seen frequently with "Russian Cocktail" abuse, a substance which can be accessed very easily and at a low cost.


Print this article     Email this article

Online since 20th March '04
Published by Wolters Kluwer - Medknow