BACKGROUND AND PURPOSE: The purpose of this report is to increase awareness on the possible long-term effects cyanide poisoning by intentional silver jewelry cleaning agent.

CASE: We report a case of a 24 year old male who developed parkinsonism after surviving acute cyanide intoxication by intentional ingestion of a now-illegal cyanide-based silver jewelry cleaner. MRI showed multiple high signal intensities in the basal ganglia, substantia nigra, and cerebral cortex consistent with the clinical and radiological findings reported rarely in literature.

DISCUSSIONS: As cyanide causes neurotoxicity by impairing oxygen utilization, this adds evidence for the affinity of cyanide for structures with high oxygen requirement. Current theories on the pathomechanism of cyanide-induced neurotoxicity are reviewed.