1/12. 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) |
2/12. Acute isoniazid neurotoxicity in childhood.Acute isoniazid (INH) poisoning is uncommon in children. Although most physicians are aware of INH hepatotoxicity, acute INH poisoning and its treatment are not well recognized. INH is increasingly being used to control the spread of tuberculosis, and physicians should know its potentially fatal effects. INH overdose is known to result in rapid onset of seizures, metabolic acidosis and prolonged obtundation. We report two cases of obtundation secondary to INH overdose that was immediately reversed by pyridoxine. Parenteral pyridoxine administration is an effective method in INH intoxication. The intravenous form of pyridoxine must be available in the emergency care units, and INH toxicity should be suspected in any patient with refractory seizures and metabolic acidosis.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
3/12. Long lasting impaired cerebral blood flow after ecstasy intoxication.Four hours after having taken 10 ecstasy tablets a Grand Mal seizure occurred in a 19-year-old woman followed by coma, hyperthermia, tachycardia, tachypnea, and renal failure. After awakening she was oriented but presented with helplessness, disconcertion, hallucinations, panic attacks, and amnesic syndrome. Computed tomography and magnetic resonance imaging scans of the brain were normal. [99Tc]-hexamethylpropyleneamine oxime (HMPAO)-single photon emission computed tomography (SPECT), 20 days after intoxication, showed reduced, inhomogeneous, supratentorial tracer uptake bilaterally. electroencephalography (EEG) disclosed diffuse slowing and occasionally generalized sharp waves. valproic acid was begun. Except for slight amnesia, neuropsychological deficits had disappeared and [99Tc]-HMPAO-SPECT normalized, 29 days later. Decreased cortical blood flow was explained by vasoconstriction following ecstasy-induced depletion of serotonin.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
4/12. Intoxication by cholinesterase inhibitors versus opioid intoxication.A 47 y-old male shopkeeper from a rural area ingested an unknown substance while under the effects of ethylic alcohol. He was admitted at the University Hospital of the Andes in generally poor condition with a cholinergic syndrome. An erroneous diagnosis of acute pulmonary edema and opioid intoxication was reached. The value of a patient's history (background) and careful evaluation of the physical examination findings without underestimating critical clinical signs are very important when handling a clinical intoxication.- - - - - - - - - - ranking = 6keywords = intoxication (Clic here for more details about this article) |
5/12. Methylbromide intoxication: a case report.This work focuses on the neurophysiological features in a patient with action myoclonus and mental deterioration following methylbromide intoxication. The patient is a 28-year-old man, without respiratory distress or exposure to other toxics. myoclonus improved with polytherapy (clonazepam, 5-HT, carbidopa, GABA). The neurophysiological and neuropsychological evidence in this patient suggests a possible double site of action of methylbromide at cortical and subcortical levels.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
6/12. An autopsied case of dentatorubropallidoluysian atrophy with atypical pathological features.This is a report of an autopsied case of dentatorubropallidoluysian atrophy (DRPLA) with atypical neuropathological findings. The patients was a 31-year-old female. Her clinical symptoms were epileptic seizures, cerebellar ataxia, choreoathetosis and dementia. A neuropathological examination revealed the fibrillary gliosis in various areas of the CNS and severe degeneration in the cerebellar cortex and nucleus fasciculi dorsalis in addition to a marked degeneration of the dentatorubropallidoluysian systems. The present case is diagnosed neuropathologically as DRPLA associated with the findings of chronic diphenylhydantoin intoxication and epileptic brain damage.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
7/12. water intoxication and hyponatremic encephalopathy from the use of an oxytocin nasal spray. A case report.Many nursing women returning to a full-time job and desiring to continue to breast feed are using oxytocin nasal sprays to facilitate breast emptying during the work day. Very few complications have been reported from its use, and the preparation has been assumed to be innocuous. However, we encountered a nursing mother whose life appears to have been jeopardized by the excessive and unmonitored application of such a spray. The patient was hospitalized for a viral illness and given a large quantity of intravenous fluid. In association with excessive self-administration of an oxytocin nasal spray, she developed severe water intoxication, with hyponatremic encephalopathy and convulsions. During the same hospitalization the patient subsequently developed a Guillain-Barre type of peripheral polyneuritis. The syndrome of inappropriate secretion of antidiuretic hormone has been reported to accompany the neurologic manifestations of the guillain-barre syndrome and may have been the cause of the convulsions. However, the temporal associations in this case strongly favor the unmonitored use of the oxytocin nasal spray as etiologic.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
8/12. Choreoathetosis during phenytoin treatment.A patient with symptomatic epilepsy receiving only phenytoin developed choreoathetosis and orofacial dyskinesias. These movement disorders disappeared when the drug was stopped and reappeared when the patient was challenged. Throughout the period of treatment, concentrations of phenytoin in serum were consistently low within the therapeutic range. Interfering symptoms from the cardiovascular system and the absence of some classic symptoms of phenytoin intoxication (nystagmus and dysarthria) contributed to delay the diagnosis. The patient died in hospital and autopsy of the brain showed rather localized encephalomalacies of corpus striatum. The pathogenic action of phenytoin and the role of preexisting brain lesions are discussed. phenytoin must be suspected as the cause, when patients on this drug present with uncontrolllable epilepsy or neurological or mental deterioration.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
9/12. Organic convergence spasm.Convergence spasm has frequently been reported as a hysterical manifestation. A case presenting with this sign and diphenylhydantoin intoxication is described. Other previously reported organic associations are discussed. Convergence spasm may be seen in association with significant organic disease of the nervous system affecting the cerebral hemispheres, the brain-stem, or both.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
10/12. Upbeating nystagmus resulting from anticonvulsant intoxication. Report of a case.A rare case of upbeating nystagmus, which occurred under the condition of a loss of visual fixation, due to anticonvulsant intoxication is reported. This patient, a 29 year old male, suffered from grand mal epilepsy for about 12 years, and he had been treated with anticonvulsive drugs. Although a neurological evaluation by a neurosurgeon could suggest the presence of a vague cerebellar sign, neuro-otological evaluation disclosed diverse abnormal findings which clearly demonstrated the presence of dysfunction in the cerebellar system, especially of the verminal and flocculonodular lobe lesion. This may indicate that the anticonvulsive drug affected the vermis and flocculonodular lobe much more than the hemisphere of cerebellum, or that the cerebellar system sign in verminal and flocculonodular lobe lesion and its connection is detected more easily than the hemispheric lesion with the aid of a neuro-otological examination. It was presumed that the upbeating nystagmus in this case was elicited from the lesion of the anterior vermis of the cerebellum and/or its connections. Usefulness and sensitivity of the neuro-otological examination in the field of dysequilibrium of central disorder as well as peripheral vestibular disorder is emphasized.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
| | Next -> |