1/7. movement disorders possibly induced by traditional chinese herbs.The authors describe the neurological presentation and CT/MRI findings in 4 patients exposed to overdoses of decoctions of two different Chinese herbs. Case 1, a 15-year-old boy, ingested herba serissae along with the safe-dosage salvia miltiorrhiza for treating a left renal stone. sophora subprostrata root (SSR) was primarily used for treating three other diseases: viral B hepatitis in case 2, a 9-year-old boy; infection of the throat and a low fever in case 3, a 11-year-old girl, and a minor facial infection in case 4, a 12-year-old boy. All patients showed complex neurological manifestations primarily including convulsions, mental changes and dystonia syndromes. Their CT and/or MRI revealed abnormal density lesions in the striatum and globus pallidus bilaterally. They excluded the possibility of Wilson's disease in each of the 4 patients and suggested that overdosage of SSR and herba serissae could cause intoxications of the central nervous system, particularly damage to the basal ganglia. Chemically, coumarin (case 1) and matrine and oxymatrine (cases 2-4) in the two medicinal herbs are suggested to be possibly responsible for the morbidity.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/7. Delayed dystonia following pimozide overdose in a child.BACKGROUND: pimozide overdose has rarely been reported in children. In adults, pimozide intoxication may cause seizures, extrapyramidal and anticholinergic effects, hypotension, QTc prolongation and torsades de pointes. We report dystonia, hypotension and drowsiness following pimozide ingestion in a child. CASE REPORT: An alert 18-month-old presented to hospital 40 minutes after ingesting up to 6 mg (0.5 mg/kg) of pimozide. vital signs: BP 91/62 mmHg, HR 130/min, RR 26/min, temperature 97.2 degrees F (36.2 degrees C). She received gastric lavage and activated charcoal. One hour later, her QTc interval was 420 msec, HR 150. She remained asymptomatic until 12 hours post-ingestion, when she developed drooling, tongue thrusting and drowsiness. BP was 75/40, HR 150, QTc 440 msec. BP increased to 95/50 after a bolus of normal saline. Her dystonia subsided over the next 12 hours without treatment. Drowsiness and tachycardia persisted until 40 hours post-ingestion. QTc interval at this time was 370 msec. Patient recovered without sequelae. CONCLUSION: pimozide overdose in children may be associated with delayed onset of symptoms, including dystonia.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
3/7. dystonia and akinesia due to pallidoputaminal lesions after disulfiram intoxication.A case with segmental cranial plus crural dystonia of delayed onset and akinesia after acute intoxication with disulfiram is presented. Computed tomography showed bilateral pallidal lesions, whereas on magnetic resonance imaging additional small lesions of the putamen could be detected. Long-term observation with progression and a change of symptoms over a period of 10 years after the intoxication is demonstrated on videotape. Although other central side effects after intoxication with disulfiram are well known, movement disorders are uncommon. carbon disulfide, a disulfiram metabolite, may be important in the etiopathogenesis.- - - - - - - - - - ranking = 7keywords = intoxication (Clic here for more details about this article) |
4/7. Clinical and CT scan findings in a case of cyanide intoxication.A 39-year-old man showed a combination of severe parkinsonism and progressive dystonia following attempted suicide with sodium cyanide. Computed tomography (CT) scan showed bilateral lucencies in the putamen and external globus pallidus. The topography of lesions on CT scan closely correlated with the pathological findings described in a previous report of cyanide-induced parkinsonism. This is the first reported case of cyanide intoxication with delayed-onset dystonia.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
5/7. Treatment with diazepam of children with drug-induced extrapyramidal symptoms.Thirteen patients with acute dystonia and extrapyramidal symptoms as a result of drug intoxication are reported. In a number of instances, the symptoms were due to more than one drug being given to the patient, among which were phenothiazine derivatives, non-phenothiazine tranquilizers and metoclopramide. diazepam (Valium) given intravenously caused the patients to fall asleep immediately and to wake within an hour, free from all symptoms. It is felt that in patients with drug-induced extrapyramidal symptoms, diazepam should be considered as the possible drug of choice.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
6/7. Delayed dystonia with striatal CT lucencies induced by a mycotoxin (3-nitropropionic acid).We describe a clinical syndrome of delayed dystonia in children subsequent to initial gastrointestinal symptoms and acute noninflammatory encephalopathy. The syndrome was caused by the ingestion of mildewed sugarcane containing the Arthrinium-produced mycotoxin, 3-nitropropionic acid (3-NPA). In the severely affected patients, intoxication usually was heralded by coma, with dystonia appearing 7 to 40 days after recovery from the coma. The dystonia was manifested as choreoathetosis, torsion spasms, or painful paroxysmal spasms of the extremities and was neither progressive nor reversible. CTs of the dystonic patients consistently showed bilateral hypodensities in the lenticular nuclei. The pathogenesis of the selective lenticular lesions induced by 3-NPA is not yet clear.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
7/7. Chronic bromvalerylurea intoxication: dystonic posture and cerebellar ataxia due to nonsteroidal anti-inflammatory drug abuse.Nalon-Ace and other nonsteroidal anti-inflammatory drugs (NSAID) containing bromvalerylurea (BVU) are sold as over-the-counter (OTC) drugs and are obtainable without prescription in japan. A 32-year-old woman was diagnosed as having chronic BVU intoxication due to habitual use of Nalon-Ace. In addition to cerebellar ataxia and pyramidal signs well known in this condition, she showed an as yet non-described dystonic posture of the neck. Laboratory tests revealed an elevated concentration of serum organic bromide, iron deficiency anemia, and hyperchloremia. brain magnetic resonance imaging (MRI) revealed definite cerebellar atrophy. We should consider the possibility of chronic BVU intoxication in peculiar neurological cases like ours.- - - - - - - - - - ranking = 6keywords = intoxication (Clic here for more details about this article) |