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. © 2007 Movement Disorder Society