Acute and chronic toxicity of ethyl chloride insufflation in two patients

Main Article Content

Jericha Viduya
Jeffrey M Levine

Abstract

Objective: Inhalant abuse has been a source of increasing concern because of its easy accessibility and affordability. Anecdotal reports have previously described ethyl chloride as a potential cause of altered mental state and neurologic symptoms. Its use has been thought to be found most often in adolescents and among men who have sex with men. Common acute symptoms include confusion, dizziness, headache, nausea, and fatigue.  We describe two cases of adult patients who presented to one general hospital emergency department with ethyl chloride toxicity. The first presented with acute delirium; the second with a picture of chronic neurological symptomatology.  It is important that clinicians become familiar with ethyl chloride intoxication because of its prevalence and potential to present with varying acute and chronic symptomatology.

Downloads

Download data is not yet available.

Article Details

How to Cite
Viduya, J., & Levine, J. M. (2021). Acute and chronic toxicity of ethyl chloride insufflation in two patients. Medical Science and Discovery, 8(11), 662–665. https://doi.org/10.36472/msd.v8i11.606
Section
Case Reports

References

Pascali J, Fais P, Viel G, Cecchetto G, Montisci M. Is old stuff back? A fatal case of ethyl chloride sniffing. Egyptian Journal Of Forensic Sciences. 2019; 9(1):29. https://doi.org/10.1186/s41935-019-0136-4.

Miech RA, Johnston LD, O'Malley PM, Bachman JG, Schulenberg JE, Patrick ME. Monitoring the future national survey results on drug use, 1975-2018: volume I, secondary school students. Ann Arbor: University of Michigan, Institute for Social Research; 2019. 586 p.

Schulenberg JE, Johnston LD, O’Malley PM, Bachman JG, Miech RA, Patrick ME. Monitoring the future national survey results on drug use, 1975–2018: volume II, college students and adults ages 19–60. Ann Arbor: University of Michigan, Institute for Social Research; 2019. 505p.

Merck, Sharpe, and Dohme. The Merck Index. An Encyclopedia of Chemicals, Drugs, and Biologicals. 13th ed. Whitehouse Station, NJ: Merck and Co., Inc.; 2001. 2165p.

Agency for Toxic Substances and Disease Registry (ATSDR). Toxicological profile for chloroethane (Update). Atlanta, GA: Public Health Service, U.S. Department of Health and Human Service; 1998. 20p.

Finch C, Lobo B. Acute inhalant-induced neurotoxicity with delayed recovery. Ann Pharmacother. 2005;39:169-172.

The Eye. Ethyl Chloride, or EC, is new off-the-shelf high. 2014, May 19. https://youtu.be/l1Z9RKDOzOk.

Hall TM, Shoptaw S, Reback CJ. Sometimes poppers are not poppers. Huffing as an emergen health concern among MSM substance abusers. J of Gay Lesbian Ment Health. 2014; 19:118-121.

Konietzko H. Chlorinated ethanes: Sources, distribution, environmental impact and health effects. Hazard Assessment of Chemicals.1984; 3:401-448.

Soult T, Walker J. Ethyl chloride intoxication. Am J Emerg Med. 1993;11:313-315.

Nordin C, Rosenqvist M, Hollstedt C. Sniffing of ethyl chloride – an uncommon form of abuse with serious mental and neurological symptoms. Int J Addict. 1988;23:623-627.

Demarest C, Torgovnick J, Sethi N, Arsura E, Sethi P. Acute reversible neurotoxicity associated with inhalation of ethyl chloride: a case report. Clin Neurol Neurosurg. 2011;113:909-910.

Broussard L, Broussard A, Pittman T, Lirette D. Death due to inhalation of ethyl chloride. J Forensic Sci. 2000;45:223-225.

Yacoub I, Robinson C, Simmons G, Hall M. Death attributed to ethyl chloride. J Anal Toxicol. 1993;17:384-385.

Haid B, White JM, Morris LE. Observations of cardiac rhythm during ethyl chloride anesthesia in the dog. Curr Res Anesth Analg. 1954; 33(5):318-325.

Morris TE, Tasto WD. 1979. Ethyl chloride. In: Grayson M, Eckroth D, eds. Kirk-Othmer encyclopedia of chemical technology. 3rd ed. Vol. 5. New York, NY: John Wiley and Sons. p714-722.

Carlisle EJ, Donnelly SM, Vasuvattakul S, Kamel KS, Tobe S, Halperin ML. Glue-sniffing and distal renal tubular acidosis: sticking to the facts. J Am Soc Nephrol 1991; 1(8):1019-1027.