Elemental Mercury Neurotoxicity From Self-Injection

We describe a Guyanese diabetic man who developed an elevation in body burdens of mercury following repeated self-injection of elemental mercury. His early signs of neurotoxicity responded to excision of the injection sites and chelation therapy. ### Case report. A 61-year-old diabetic man presented with burning pain in the feet and tremor of the hands. During his 20 years of insulin-dependent diabetes, his most common insulin injection sites were the forearms and abdominal wall. About 4 to 6 years earlier, he first experienced burning discomfort in the feet, attributed initially to his diabetes. This intensified, and a tremor appeared shortly thereafter, which had gradually become disabling. His handwriting steadily progressed to illegibility, and it was difficult for him to drink from a glass without spillage. In the past 4 years he also noticed the appearance of raised black protuberant scars over his volar forearms and abdomen at the usual injection sites. Examination disclosed numerous raised, …