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Methoxetamine associated reversible cerebellar toxicity: three cases with analytical confirmation
Jennifer E Shields1, Paul I Dargan, David M Wood
1Acute Medical Unit, York Teaching Hospital NHS Foundation Trust, York, UK.
Clinical Toxicology (Philadelphia, Pa.)
|May 15, 2012
Summary
Methoxetamine (MXE) exposure can cause rapid neurological impairment, specifically acute cerebellar toxicity. While recovery is spontaneous, symptoms may last several days, highlighting the need for clinical awareness.
Area of Science:
- Neuroscience
- Toxicology
- Pharmacology
Background:
- Increasing use and accessibility of methoxetamine (MXE), a ketamine derivative, raise concerns.
- Limited data exist on the clinical features of methoxetamine exposure.
- This study investigates acute neurological toxicity following confirmed methoxetamine exposure.
Observation:
- Three cases of acute neurological toxicity after methoxetamine (MXE) use are presented.
- Symptoms included severe cerebellar ataxia, nystagmus, incoordination, and reduced consciousness.
- Nasal insufflation was the route of administration in all cases.
Findings:
- Confirmed methoxetamine (MXE) exposure in all patients via toxicological screening.
- Serum methoxetamine concentrations ranged from 0.16 to 0.45 mg/L.
- Neurological impairment, particularly cerebellar toxicity, resolved within 24 hours to 3-4 days.
Implications:
- Methoxetamine (MXE) can induce rapid-onset neurological impairment with acute cerebellar toxicity.
- Clinicians should consider methoxetamine exposure in cases presenting with an acute cerebellar toxidrome.
- Spontaneous recovery is typical, but may be prolonged, necessitating prompt diagnosis and supportive care.
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