To the Editor: We report on a 22-year-old man who has a 9-year history of glue-sniffing that evolved into a full-blown picture of psychological dependency that was characterized by craving and tolerance, which was subsequently followed by agitation, irritability, and physical struggle. It gradually ended with period of low mood, lack of motivation, and social withdrawal. The disturbance was punctuated by episodes of florid psychosis during intoxication, which included visual hallucination and disorganized behavior. After 6 years of chronic glue-sniffing, there was an insidious onset of bilateral, low-frequency intention tremors involving the upper limbs that gradually worsened and was accompanied by unstable gait, stuttering of speech, and blurring of vision. There was no history to suggest seizure disorder or any infection of the central nervous system. There was a 1-year delay before presentation to medical services due to shame and guilt feelings about coming out of the house because of the physical problems. Mental state examination (MSE) revealed presence of scanning speech and impairment of abstract thinking. He scored 26/30 on Mini-Mental State Exam (MMSE). He had bilateral, persistent, horizontal, pendular nystagmus, and bilateral intention tremors of the hands, broad-based gait, past pointing and dysdiadokinesia of the upper limbs, which were more prominent on the right side. Further examination revealed optic atrophy of the right eye, but sensorimotor functions were normal, and muscle wasting was absent.