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Reversible Neurotoxicity Due To Excessive Use of Ethyl Chloride.

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Recreational ethyl chloride (EC) huffing can cause severe neurotoxicity, leading to ataxia and gait disturbances. This rare complication typically resolves with supportive care, highlighting the need for physician awareness.

Keywords:
LGBTMSMataxiaethyl chloridehuffingneurotoxicitypoppersragging

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Area of Science:

  • Neuroscience
  • Toxicology
  • Emergency Medicine

Background:

  • Ethyl chloride (EC) is a chemical with various commercial uses, including as a topical anesthetic and gasoline additive.
  • A growing trend involves recreational huffing of EC, often for enhancing sexual experiences.
  • While neurotoxicity from chronic EC abuse is uncommon, acute toxicity can occur.

Observation:

  • A 36-year-old male presented with acute, severe ataxia and inability to walk after a week of escalating ethyl chloride inhalation.
  • Physical examination revealed slurred speech, ptosis, nystagmus, dysmetria, and a wide-based, ataxic gait.
  • Neurological imaging (CT/MRI) of the brain and spine showed no abnormalities, and laboratory tests were unremarkable.

Findings:

  • The patient's neurotoxicity, characterized by cerebellar signs and ataxia, was directly linked to excessive ethyl chloride huffing.
  • Despite the severity of symptoms, neurological function significantly improved with supportive care.
  • Recovery of ambulation was observed by hospital day 9.

Implications:

  • This case highlights a rare but serious neurotoxic complication of recreational ethyl chloride abuse.
  • Emergency physicians should be aware of the potential for severe ataxia and cerebellar dysfunction from EC huffing.
  • Prompt recognition and supportive management are crucial for patients presenting with ethyl chloride-induced neurotoxicity.