Manganese Encephalopathy Caused by Homemade Methcathinone (Ephedrone) Prevalence in Poland
Abstract
:1. Introduction
- Body posture
- sometimes leading to backward falls,
- Propulsion and/or retropulsion,
- Characteristic dystonic disturbances in the facial muscles
- a forced smile grimace (reminiscent of "risus sardonicus"),
- Dysarthria (speech significantly reduced to anarthria in advanced cases, monotonous speech) [8],
- Extrapyramidal symptoms, such as:
- muscle stiffness,
- slowdown,
- impaired movement,
- impaired facial expressions,
- difficulties in precise movements, mainly of the hands,
- micrograph (writing in smaller and smaller letters),
- Pseudobulbar symptoms: inadequate, forced laughter or crying,
2. Materials and Methods
3. Results
3.1. Questionnaire
3.2. Intravenous Methcathinone Use and Manganese Encephalopathy Symptoms
3.3. Professional Knowledge of Manganese Encephalopathy
- 13 centers (18%) assessed their staff’s knowledge of manganese encephalopathy as none;
- 11 of them (15.3%) declared the need for training;
- 2 did not see such a need due to the currently “non-medical nature” of their center;
- 38 centers (52.8%) declared minimal knowledge in this area;
- 21 centers (29.2%) declared sufficient competence in dealing with people with suspected manganese encephalopathy;
- of which 15 (20.1%) considered that they could still be further trained.
4. Discussion
5. Limitations of the Study
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. The Questionnaire on the Prevalence of Manganese Encephalopathy among Patients of Addiction Treatment Centers
- Center:
- Inpatient.
- Detoxifying.
- Rehabilitation.
- Other (what kind? …).
- Outpatient.
- Inpatient and outpatient.
- Other (what kind? …).
- In the last six years approx. … patients addicted to substances (other than alcohol) were treated in our center (please provide the number of patients)
- Of them, about … (please provide the number of patients) used intravenous ephedrone preparations from medicines containing pseudoephedrine (Sudafed, Acatar, etc.) - prepared with potassium permanganate.
- In the last six years we had approx. … (please provide the number) patients whose clinical picture was very similar to the description of manganese encephalopathy that was given in the cover letter of this questionnaire and the review papers.
- In the last six years we had approx. … (please provide the number) patients who developed single (up to 3) symptoms listed in the clinical description as above.
- About … (please provide the number) of patients had had above mentioned symptoms also before 2010′.
- The management of patients with suspected manganese encephalopathy (please mark appropriate):
- The suspicions were quickly verified by neurologist who performed MRI of thebrain, as well as measured blood manganese levels.
- The patients were referred to neurologists who did not verify the suspicion of themanganese encephalopathy or did not provide recommendation for the treatment.
- Patients were referred to other medical centers.
- We were not aware of the possibility of any further diagnosis of patients.
- We were unable to refer patients for further examinations due to:
- lack of patients’ insurance.
- refusal from other medical centers.
- other (please specify)…
- The phenomenon of using ephedrone and the manganese preparations (please mark appropriate):
- Lasts for many years, also before 2010′ and has not undergone major changes.
- Intensified after the introduction of the legal changes in 2010.
- The legal changes introduced in 2010 had reduced the use of this preparation.
- It’s hard to say.
- What is the level of knowledge about the manganese encephalopathy in medical staff of your center?
- None and they do not need training.
- None and they do need training.
- Minimal but and they do not need training.
- Minimal and they do need training.
- Sufficient and they do not need training.
- Sufficient, but training can increase their competence.
- Excellent and they do not need training.
- Attached information about manganese encephalopathy:
- Significantly and sufficiently increased the alertness of the staff to this disorder.
- Did not change our treatment policy because the staff is familiar with clinical symptoms of manganese encephalopathy.
- Is unnecessary.
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---|---|---|---|---|---|
Sikk et al. [61] | 2011 | Estonia | 20 | 17:3 | - |
Sikk et al. [62] | 2013 | Estonia | 38 | 31:7 | 33 |
Sikk et al. [62] | 2013 | Estonia | 24 | - | - |
Khatiashvili et al. [36] | 2007 | Georgia | 10 | - | - |
Chinchaladze et al. [63] | 2012 | Georgia | 22 | - | - |
Giorgishvili et al. [64] | 2016 | Georgia | 3 | - | - |
Bonnet et al. [65] | 2014 | Georgia | 28 | 27:1 | - |
Rusz et al. [8] | 2014 | Georgia | 28 | - | 39.9 +/−4.9 |
Stepens et al. [37] | 2010 | Latvia | 10 | 8:2 | 40 (30–55) |
Stepens et al. [38] | 2011 | Latvia | 23 | - | - |
Stepens et al. [7] | 2014 | Latvia | 18 | 17:1 | 36.5 (23–47) |
Golasik et al. [48] | 2014 | Poland | 24 | 17:7 | |
Levin [35] | 2005 | Russia | 21 | 14:7 | - |
Ismailova et al. [66] | 2005 | Russia | 65 | 60:5 | - |
Fedorova et al. [33] | 2007 | Russia | 65 | - | - |
Levin & Datieva [34] | 2013 | Russia | 35 | - | - |
Sanotsky et al. [58] | 2007 | Ukraine | 13 | 13:0 | - |
Selighova et al. [67] | 2008 | Ukraine | 13 | 13:0 | - |
Djamshidian et al. [68] | 2012 | Ukraine | 15 | - | - |
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Habrat, B.; Silczuk, A.; Klimkiewicz, A. Manganese Encephalopathy Caused by Homemade Methcathinone (Ephedrone) Prevalence in Poland. Nutrients 2021, 13, 3496. https://doi.org/10.3390/nu13103496
Habrat B, Silczuk A, Klimkiewicz A. Manganese Encephalopathy Caused by Homemade Methcathinone (Ephedrone) Prevalence in Poland. Nutrients. 2021; 13(10):3496. https://doi.org/10.3390/nu13103496
Chicago/Turabian StyleHabrat, Bogusław, Andrzej Silczuk, and Anna Klimkiewicz. 2021. "Manganese Encephalopathy Caused by Homemade Methcathinone (Ephedrone) Prevalence in Poland" Nutrients 13, no. 10: 3496. https://doi.org/10.3390/nu13103496
APA StyleHabrat, B., Silczuk, A., & Klimkiewicz, A. (2021). Manganese Encephalopathy Caused by Homemade Methcathinone (Ephedrone) Prevalence in Poland. Nutrients, 13(10), 3496. https://doi.org/10.3390/nu13103496