1/27. Neurological sequelae after lithium intoxication.Severe lithium intoxication was seen in a 57-year-old woman despite close monitoring of blood lithium levels over 23 months. High blood lithium levels were aggravated by drug induced hyponatremia. Neurological sequelae were still present six months after admission,- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/27. 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 = 0.8keywords = intoxication (Clic here for more details about this article) |
3/27. Chronic neuropsychological and neurological impairment following acute exposure to a solvent mixture of toluene and methyl ethyl ketone (MEK).A 38 year-old laborer experienced solvent intoxication during each of two spray paintings of a dump truck and other heavy equipment in an enclosed, unventilated garage. The paint base consisted primarily of toluene and methyl ethyl ketone. nausea, headaches, dizziness, respiratory difficulty and other symptoms began after exposures. Over the next several days he developed impaired concentration, memory loss and cerebellar signs including an intention tremor, gait ataxia and dysarthria. MRI of the brain and EGG early in the work-up were normal, although later MRIs demonstrated fluid collection over the left parietal area. Examination by a toxicologist and neurologist revealed likely toxic encephalopathy with dementia and cerebellar ataxia. Three formal neuropsychological assessments over 2 1/2 years quantified cognitive, motor and behavioral changes. Despite similar findings in chronic exposure to these solvents, lasting sequelae following acute exposure have not been widely reported.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
4/27. Encephalopathy and neuropathy following ingestion of a Chinese herbal broth containing podophyllin.Two patients developed podophyllin intoxication following ingestion of a broth of the Chinese herb guijiu. The neurological manifestations are described and the pathology of the peripheral neuropathy is fully documented with ultrastructural and quantitative studies.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
5/27. Polyneuropathy induced by m-tolyl methyl carbamate intoxication.A 55-year-old woman who attempted suicide by ingesting 200 ml of m-tolyl methyl carbamate (MTMC) is reported. She was comatose for 3 days and, upon recovery, had notable paraesthesia in her lower limbs and difficulty in walking. Neurological examination revealed sensorimotor polyneuropathy. sural nerve biopsy revealed marked axonal degeneration with a moderate decrease of myelinated fibres.- - - - - - - - - - ranking = 0.8keywords = intoxication (Clic here for more details about this article) |
6/27. Acute polyneuropathy after malathion poisoning.We report a patient in whom intoxication with a commercial preparation of malathion led to a severe acute cholinergic crisis, protracted cardiac arrhythmias, an acute respiratory distress syndrome, and an acute sensorimotor axonal polyneuropathy. The occurrence of the polyneuropathy was associated with a novel malathion transformation product, S-(1-ethoxycarbonyl, 2-isopropoxycarbonyl) ethyl 0,0-dimethyl phosphorodithioate (isopropylmalathion), an impurity present in the pesticide residue. The role of isopropylmalathion in the pathophysiology of the polyneuropathy remains to be determined.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
7/27. lead intoxication in an anuric patient: management by intraperitoneal EDTA.Treatment of lead intoxication with intravenous ethylene-diamine-tetra-acetic acid (EDTA) depends on the urinary excretion of chelated lead. This route of excretion was absent in a 48-year-old patient with childhood lead exposure and end stage renal failure who developed encephalopathy and a rapidly progressive neuropathy thought to be due to acute lead intoxication. diagnosis was confirmed by lead chelation with EDTA and neurophysiological studies. EDTA was added by the patient to her chronic ambulatory peritoneal dialysis (CAPD) fluid each week and chelated lead excreted in the dialysate. Intraperitoneal administration of EDTA was 70% as efficient in removing lead as intravenous administration. Four months of home chelation therapy was associated with resolution of the encephalopathy but no improvement in the peripheral neuropathy.- - - - - - - - - - ranking = 1.2keywords = intoxication (Clic here for more details about this article) |
8/27. Aviators intoxicated by inhalation of JP-5 fuel vapors.This case of intoxication of two aviators by inhalation of JP-5 fuel vapors emphasizes a dangerous safety hazard. One or both aviators experienced burning eyes, nausea, fatigue, impairment of eye-hand coordination, euphoria, and memory defects when their cockpit became overwhelmed with the odor of JP-5 fuel. Physical and laboratory examinations were normal except for their ill appearance, conjunctivitis, and mild hypertension, which resolved without sequelae. Exposure to JP-5 fuel vapor occurs frequently, particularly after acrobatic flight in some aircraft. The neurologic effects and insidious nature of intoxication makes continued operation under such conditions extremely hazardous. The following is recommended: in the event the odor of JP-5 or any noxious or irritating substance is detected in the cockpit, serious consideration should be given to terminating the flight, using precautionary emergency landing procedures and 100% O2.- - - - - - - - - - ranking = 0.4keywords = intoxication (Clic here for more details about this article) |
9/27. Severe lithium toxicity treated by hemodialysis: a case report.A 51-year-old manic woman who developed acute severe lithium intoxication with neurotoxicity and nephrotoxicity during rapid abatement of manic episode was reported. The underlying causes of the serious toxicity were reviewed. awareness and early detection of the toxic symptoms are emphasized in order to avoid permanent toxic sequelae. It is suggested that hemodialysis is the treatment of choice and should not be delayed, especially in severe toxic states and a daily 10 hours hemodialysis is needed to prevent the rebound effect as lithium in intracellular fluid equilibrates with extracellular fluid.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
10/27. The syndrome of irreversible lithium-effectuated neurotoxicity (SILENT).Though the acute complications of lithium toxicity involving the central nervous system have been known for more than 70 years, it is only recently that the longlasting sequelae of lithium intoxication have come to be discussed at length; about fifty-five cases have been reported so far. The acronym SILENT (syndrome of Irreversible lithium-Effectuated Neurotoxicity) has been coined recently to denote these sequelae. The present report describes the typical profile of SILENT (persisting cerebellar dysfunction) and suggests measures to decrease the incidence of this potentially serious condition, for which no definitive treatment is available.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
| | Next -> |