Chronic parkinsonism secondary to intravenous injection of meperidine analogues
Abstract
Abuse of 4-propyloxy-4-phenyl-N-methylpiperidine, a meperidine congener, produced parkinsonism in a 23-year-old man. Unlike other drug-induced motor disturbances, the syndrome perisited for 18 months and responded to drugs that stimulate dopamine receptors. Biogenic amines and metabolites in the cerebrospinal fluid and microscopic evaluation of the brain at necropsy were consistent with damage to aminergic neurons in the substantia nigra.
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The authors would like to acknowledge Dr. M. Valsamis, neuropathologist, Dr. V. Dolan of the Medical Examiner's Office, Baltimore, MD, and Mr. R.I. Eisenberg for photography.