A patient presents to the ED with altered mental status, ataxia, skin rash and cogwheel rigidity. Imaging reveals a leukoencephalopathy. What is a likely culprit?
Chronic ingestion of mothballs or toilet cakes containing paradichlorbenzene can result in leukoencephalopathy. (Dubey D et al. Para-dichlorobenzene toxicity – a review of potential neurotoxic manifestations. Ther Adv Neurol Disord. 2014 May; 7(3): 177–187. doi: 10.1177/1756285614521889)