1/9. Persistent cerebellar deterioration in a patient with lobar pneumonia under lithium, carbamazepine, and trifluperidol treatment.We report on a patient with schizoaffective disorder who was on combination therapy of lithium, carbamazepine, and the neuroleptic trifluperidol. He experienced a lobar pneumonia and developed an acute and persistent cerebellar deterioration which was most likely due to lithium toxicity, while the serum lithium level was within the therapeutic range. The combination of lithium, carbamazepine, and neuroleptics is common, and is generally considered to be safe. The reported case suggests that this regimen might increase the risk of intoxication with potentially disabling side-effects.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/9. phenytoin overdose complicated by prolonged intoxication and residual neurological deficits.This report describes a case of massive phenytoin deliberate self-poisoning, notable for delayed peak serum concentrations, multiple general complications, and permanent cerebellar injury. A 38-year-old 70 kg male patient presented to the ED after ingestion of at least 10 g of phenytoin 12-16 h earlier. Marked cerebellar dysfunction and persistent vomiting were observed, with an initial serum phenytoin concentration of 181 micromol/L. Initial conservative treatment (activated charcoal, whole bowel irrigation), and later attempts at charcoal haemoperfusion were unsuccessful. The serum phenytoin concentration peaked on day 15 (354 micromol/L). The patient developed seizures followed by a prolonged depression in conscious state requiring intubation. Multiple medical sequelae occurred and the patient was discharged to a rehabilitation facility 100 days after admission exhibiting signs consistent with permanent cerebellar dysfunction.- - - - - - - - - - ranking = 4keywords = intoxication (Clic here for more details about this article) |
3/9. Methyl bromide intoxication causes reversible symmetric brainstem and cerebellar MRI lesions.Methyl bromide is toxic to the central and peripheral nervous systems. A patient with occupational exposure to this agent is described. MRI showed strikingly symmetric brainstem and cerebellar lesions. The patient's clinical course and the topography and resolution of his MRI abnormalities suggest that this condition is an energy deprivation syndrome.- - - - - - - - - - ranking = 4keywords = intoxication (Clic here for more details about this article) |
4/9. Cerebellar atrophy following acute intoxication with phenytoin.A patient developed marked cerebellar atrophy after a single suicidal intoxication with 7 grams phenytoin. The clinical signs of cerebellar dysfunction subsided very slowly and incompletely within 18 months. We documented the cerebellar atrophy by CTs 4 weeks and 1 year after the intoxication, and we suggest that a single severe acute intoxication with phenytoin may directly cause cerebellar degeneration.- - - - - - - - - - ranking = 7keywords = intoxication (Clic here for more details about this article) |
5/9. A case of lithium intoxication with downbeat vertical nystagmus.lithium carbonate has recently been used in the treatment of manic diseases. However, since the marginal range between therapeutic and toxic doses is very narrow, close attention should be paid to the development of adverse reactions in its application. Lithium intoxication is manifested by neurological symptoms. Neurotological tests were performed on a patient with lithium intoxication that occurred in the course of psychiatric treatment of mania. The observed sequelae included marked downbeat vertical nystagmus and truncal ataxia. The main lesions in the present case were considered to be located in the cerebellum. Close observation, including neurotological tests, is of greatest importance because in cases of lithium intoxication the development of cerebellar as well as brainstem disorders must not be overlooked.- - - - - - - - - - ranking = 7keywords = intoxication (Clic here for more details about this article) |
6/9. Lead encephalopathy: symptoms of a cerebellar mass lesion and obstructive hydrocephalus.The neurologic signs and symptoms of lead intoxication are quite varied. We review a case of lead poisoning in a 9-month-old child who presented clinically and radiographically with a posterior fossa mass effect and obstructive hydrocephalus. The predominance of edema of the cerebellum sufficient to achieve obstruction of the ventricular system represents a particularly unusual presentation of this disease process. review of the literature for similar cases of lead encephalopathy is included.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
7/9. Neuropathologic correlates of persistent neurologic deficit in lithium intoxication.While acute neurological symptoms complicating lithium therapy are well recognized, persistent neurologic dysfunction is uncommon. Regardless of the duration of symptoms, neuropathological correlates of lithium toxicity are few. We report the case of a 67-year-old man who developed lithium toxicity manifested by encephalopathy and coma followed by persistent dysarthria and ataxia. autopsy revealed neuronal loss and gliosis in the cerebellar cortex and dentate nuclei; the cerebellar white matter exhibited prominent spongy change. Persistent cerebellar syndrome may occur with lithium intoxication and should be considered in the differential diagnosis of chronic cerebellar dysfunction.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
8/9. Methyl iodide poisoning: report of two cases.Two workers were poisoned following exposure to methyl iodide with inadequate protective devices. Their cases are presented together with a review of literature. Both patients developed symptoms and signs of cerebellar lesions and damage of the third, fourth, or sixth cranial nerve pathways. spinal cord lesions producing motor and sensory disturbances were present in one. Late psychiatric disorders were observed in both patients. Although these symptoms were very similar to those reported in the nine published cases of methyl iodide poisoning, the toxicological diagnosis was delayed in one case: as repeated overexposure produced recurrent attacks of multifocal neurological dysfunction, multiple sclerosis was initially diagnosed, although several of the features observed are unusual in this disease. The manifestations of methyl iodide poisoning are similar to those of intoxication with other monohalomethanes. All these compounds probably share the same mechanisms of action. This mechanism and its therapeutic consequences are discussed.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
9/9. Cerebellar atrophy after acute phenytoin intoxication.There is some evidence that long-term phenytoin (PHT) use may occasionally give rise to irreversible cerebellar atrophy, but it is unclear whether such changes can occur after acute PHT intoxication. We describe a 38-year-old patient with accidental acute PHT overdose who developed severe cerebellar atrophy. This case provides evidence that acute PHT intoxication can, on rare occasions, result in irreversible cerebellar degeneration.- - - - - - - - - - ranking = 6keywords = intoxication (Clic here for more details about this article) |