Mothball withdrawal encephalopathy - Case report and review of paradichlorobenzene neurotoxicity

Raymond Cheong, Robin K. Wilson, Irene C.M. Cortese, David E. Newman-Toker

Research output: Contribution to journalArticle

Abstract

Paradichlorobenzene (PDB) is a common household deodorant and pesticide found in room deodorizers, toilet bowl fresheners, and some mothballs. Although human exposure to the compound is generally limited and harmless, PDB in larger doses can produce neurotoxic effects, including a chemical "high" similar to that seen with inhalants such as toluene. Although rare, frank addiction to PDB has been reported, and, in such cases, has been associated with gait ataxia, tremor, dysarthria, limb weakness, and bradyphrenia, in various combinations. In such cases, the adverse neurologic consequences have been presumed to result from a direct toxic effect of this small, organic molecule. We report a case of chronic mothball ingestion where profound encephalopathy with cognitive, pyramidal, extrapyramidal, and cerebellar features appears to have been largely the result of PDB withdrawal, rather than direct toxicity. This case raises important questions about the mechanism of PDB neurotoxicity and possible treatment options for PDB-addicted patients. We propose that in cases with clear clinical deterioration after abstinence, readministration and gradual taper of PDB might be considered a therapeutic option.

Original languageEnglish (US)
Pages (from-to)63-67
Number of pages5
JournalSubstance Abuse
Volume27
Issue number4
DOIs
StatePublished - Mar 5 2007

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Keywords

  • 2-dichlorobenzene
  • Basal ganglia diseases
  • Catatonia
  • Neurotoxicity syndromes
  • Substance withdrawal syndrome
  • Substance-related disorders

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health

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