Document Detail

Mothball withdrawal encephalopathy: case report and review of paradichlorobenzene neurotoxicity.
MedLine Citation:
PMID:  17347127     Owner:  NLM     Status:  MEDLINE    
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.
Raymond Cheong; Robin K Wilson; Irene C M Cortese; David E Newman-Toker
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Substance abuse : official publication of the Association for Medical Education and Research in Substance Abuse     Volume:  27     ISSN:  0889-7077     ISO Abbreviation:  Subst Abus     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2007-03-09     Completed Date:  2007-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8808537     Medline TA:  Subst Abus     Country:  United States    
Other Details:
Languages:  eng     Pagination:  63-7     Citation Subset:  IM    
Medical Scientist Training Program, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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MeSH Terms
Administration, Oral
Chlorobenzenes / administration & dosage,  toxicity*
Chlorophenols / urine
Diagnosis, Differential
Follow-Up Studies
Gait Ataxia / chemically induced,  diagnosis
Insecticides / toxicity*
Mutism / chemically induced,  diagnosis
Neurologic Examination / drug effects
Neuromuscular Diseases / chemically induced,  diagnosis
Neurotoxicity Syndromes / diagnosis*
Substance Withdrawal Syndrome / diagnosis*,  rehabilitation
Substance-Related Disorders / rehabilitation*
Reg. No./Substance:
0/Chlorobenzenes; 0/Chlorophenols; 0/Insecticides; 106-46-7/4-dichlorobenzene; 583-78-8/2,5-dichlorophenol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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