1/8. Spasticity due to phenytoin toxicity.A young epileptic presented with spasticity as well as ataxia, diplopia and nystagmus; his serum phenytoin level was very high. All the abnormal signs disappeared after withdrawal of phenytoin. Spasticity, hyperreflexia, and clonus are features of phenytoin intoxication, present in this case, which are not commonly seen, and which have rarely been mentioned previously in the literature.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/8. Altered mental status and ataxia secondary to acute kava ingestion.kava has traditionally been used for a variety of purposes in the tropical islands of polynesia but is becoming more frequently available in the united states health supplement market due to its calming effects in patients with anxiety. The side effect profile is poorly known but has recently gained the attention of the food and Drug Administration (FDA). Although hepatitis and liver failure have been described with chronic ingestion, the effects of acute overdose are poorly described. We present a case of acute kava overdose resulting in altered mental status and ataxia similar to that seen with ethanol intoxication.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
3/8. Delayed hyperbaric oxygen therapy for carbon monoxide intoxication--two case reports.The severity of signs and symptoms following carbon monoxide intoxication often does not relate to admission carboxyhaemoglobin levels. Two cases are presented with severe neurological impairment despite carboxyhaemoglobin levels of 2% and 1.7% on admission to hospital, who responded well to hyperbaric oxygen therapy. In one case, symptoms recurred several days later, but responded to further hyperbaric oxygen therapy. The role of and possible mechanism of action of late hyperbaric oxygen treatment in carbon monoxide intoxication are discussed.- - - - - - - - - - ranking = 6keywords = intoxication (Clic here for more details about this article) |
4/8. Acute and chronic progressive encephalopathy due to gasoline sniffing.Acute encephalopathy caused by gasoline sniffing is well recognized, but has been thought to be completely reversible. We report a patient who developed a progressive encephalopathy characterized by ataxia, tremor and dementia following repeated, deliberate gasoline inhalation. blood and urine lead levels were consistently elevated and at autopsy, the formalin-fixed brain lead content was between 5200 and 6500 micrograms/100 gm of tissue. This case shows that repeated gasoline sniffing can result in irreversible encephalopathy and that both the acute and chronic encephalopathy probably result from organic lead intoxication and not from the gasoline itself.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
5/8. Downbeat nystagmus with phenytoin.Downbeat nystagmus is generally the result of a structural lesion at the craniocervical junction. It has rarely been reported as a manifestation of metabolic disease or drug intoxication. We observed two patients with downbeat nystagmus secondary to phenytoin (Dilantin) intoxication. Both individuals had other features of phenytoin-induced central nervous system dysfunction with toxic blood levels of the drug (greater than 20 micrograms/ml). Complete resolution of the downbeat nystagmus followed the return of phenytoin levels to the therapeutic range.- - - - - - - - - - ranking = 2keywords = intoxication (Clic here for more details about this article) |
6/8. Massive dextromethorphan ingestion and abuse.The case of a 23-year-old man who was acutely intoxicated on dextromethorphan and who was chronically addicted to the drug is described. He consumed the highest daily dose for the longest duration yet reported in the world's English-language medical literature. Toxicity, abuse potential, and therapy of dextromethorphan intoxication are discussed.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
7/8. phenytoin toxicity from smoking crack cocaine adulterated with phenytoin.Drugs of abuse often are adulterated with agents designed to lower cost or alter the intoxication. Recently, we began to hear of the intentional addition of phenytoin to crack cocaine. We report the cases of five patients with measurable phenytoin levels attributable to smoking crack cocaine adulterated with phenytoin. Three of these patients presented with signs, symptoms, and phenytoin levels consistent with phenytoin toxicity. Clinicians should be aware of this practice when faced with cocaine users with altered mental status, ataxia, or nystagmus.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
8/8. germanium intoxication with sensory ataxia.Sensory ataxia in inorganic germanium intoxication is rare. A 63-year-old housewife had taken inorganic germanium preparations at a dosage of 36 mg a day for about 6 years (total dose about 80 g). She subsequently developed difficulty in writing and gait disturbance with peripheral neuropathy and renal involvement. germanium, which is not usually detected in the non-germanium user, was accumulated in her hair and nails, permitting a diagnosis of inorganic germanium intoxication. The peripheral neuropathy and renal injury were not reversible after discontinuing the preparation. pneumonia and sepsis then supervened and the patient died. autopsy findings showed degeneration and loss of the dorsal root ganglion cells and degeneration of the dorsal column of the spinal cord. Two previously reported cases presented with ataxia. These patients took germanium for long periods and/or large quantities like our case. It was supposed that sensory ataxia was induced by chronic and dose dependent toxicity of inorganic germanium.- - - - - - - - - - ranking = 6keywords = intoxication (Clic here for more details about this article) |