11/19. Major depression and carbon monoxide-induced parkinsonism: diagnosis, computerized axial tomography, and response to L-dopa.A case of major depressive disorder complicated by carbon monoxide (CO)-induced Parkinson's syndrome is reported. Computerized axial tomography (CAT) revealed bilateral globus pallidus necrosis. Clinical, CAT, and neuropathological findings in other cases of CO encephalopathy with and without parkinsonism are reviewed. The utility of CAT in the diagnostic workup and in following clinical course is discussed, as are the difficulties of making a diagnosis of an antecedent primary psychiatric disorder in the presence of neurological and psychiatric sequelae of CO intoxication. There was no clinical response to a tricyclic antidepressant, but both the mood and movement disorders responded fully to L-dopa. The implications of these findings with regard to the central neurochemical pathophysiology in this patient and in major depressive disorder in general are discussed.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
12/19. 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) |
13/19. Single case study. Possible organophosphate-induced parkinsonism.A case of possible organophosphate-induced parkinsonism is presented. The patient was a crop duster with numerous episodes of acute organophosphate intoxication and chronic organophosphate exposure. The etiology of parkinsonism is discussed in terms of a balance hypothesis between cholinergic and dopaminergic neurotransmission in the striatum. A possible relationship between chronic organophosphate exposure and alterations in central cholinergic or dopaminergic activity is suggested. The course of this patient raises the possibility that agricultural workers may be at risk for the late development of parkinsonism.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
14/19. Parkinsonian syndrome after methanol intoxication.This is a report of a case of acute methanol intoxication (AMI) with an exceptional central nervous system (CNS) damage producing a parkinsonian syndrome. This symptomatology persisted as a sequel. Computed axial tomography (CAT) scan showed areas of decreased attenuation at lenticulocapsular regions. The authors remark on the correlation of these CAT scan abnormalities and the pathological findings in necropsy studies described in the literature. They think that these lesions are produced by severe methanol intoxications, generally with a fatal outcome. They suggest the CAT scan diagnostic utility in patients with metabolic acidosis and coma of unknown etiology.- - - - - - - - - - ranking = 6keywords = intoxication (Clic here for more details about this article) |
15/19. Parkinsonism provoked by alcoholism.Seven chronic alcoholics, aged 53 to 70, demonstrated transient signs of parkinsonism provoked by alcohol withdrawal or chronic severe intoxication. All showed improvement or recovery when they abstained or decreased their alcohol intake for several days to weeks. Animal studies have demonstrated impaired striatal dopaminergic function during severe ethanol intoxication or withdrawal. Chronic alcoholism apparently can exacerbate or uncover latent central dopaminergic deficiency.- - - - - - - - - - ranking = 2keywords = intoxication (Clic here for more details about this article) |
16/19. The enigma of parkinsonism in chronic borderline mercury intoxication, resolved by challenge with penicillamine.A 47 year old female dentist suffered from hemiparkinsonism which had started eighteen months earlier and was manifested mainly by resting tremor and cogwheel rigidity. A baseline quantitative urinary mercury excretion was 46 micrograms/day. The patient was treated with chelating agent d-penicillamine for a week. chelation therapy resulted in clinical improvement of parkinsonism and in dynamic changes in daily urinary mercury excretion with a prompt increase to 79 micrograms/day, a subsequent decline followed by increase in the mercury urinary excretion. After a week chelation therapy was stopped. During a follow-up period of five years, the neurological status remained unchanged after the initial penicillamine-induced improvement. This case may be evidence, therefore, of a rare clinical variant of elemental mercury intoxication associated with parkinsonism, in the absence of most classical neuropsychiatric signs of chronic mercurialism.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
17/19. Chronic intoxication with lead- and sulfur compounds may produce Parkinson's disease.Parkinson's disease was found in three post office workers who were in close contact with lead-sulfate batteries over a period between 1947 and 1983. The workers had been working in a charging station for lead storage batteries used for the battery-traction of post wagons. Parkinson's disease was diagnosed by the characteristic features of rigidity, tremor and elements of hypo-, brady- and akinesia. Additional symptoms were: bradyphrenia (n = 3), memory deficits (n = 3), depressive symptoms (n = 2) and peripheral neuropathy (n = 2). We hypothesize that the parkinsonian symptoms of these post office workers are primarily caused by lead or lead compounds. However a possible toxicity of sulfur containing compounds cannot be ruled out.- - - - - - - - - - ranking = 4keywords = intoxication (Clic here for more details about this article) |
18/19. Accidental choke-cherry poisoning: early symptoms and neurological sequelae of an unusual case of cyanide intoxication.We report the case of a 56-year-old woman who was accidentally poisoned when she ingested choke cherries whose pulp contained cyanide, and describe the acute clinical picture, the neurological sequelae and the neuroradiological findings. After recovery from coma, the patient showed signs of a parkinsonian syndrome, retrobulbar neuritis and sensory-motor neuropathy. MRI showed abnormal signal intensities involving the basal ganglia. Since no memory deficits were observed, we argue that the parkinsonian syndrome was caused by cyanide intoxication rather than by subcortical damage due to hypoxia.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
19/19. manganese induced parkinsonism: a case report.manganese (Mn) intoxication is known to induce parkinsonism. Mn-induced parkinsonism preferentially affect the globus pallidus in contrast to idiopathic parkinsonism where degeneration predominantly involves the nigral pars compacta. We describe a 51-year-old man who had been occupationally exposed to Mn. He had parkinsonian features including masked face, resting tremor, and bradykinesia. He also had a cock walk and a particular propensity to fall in a backward gait. There was no sustained therapeutic response to levodopa. A fluorodopa PET scan was normal. This case indicates that Mn-induced parkinsonism can be differentiated from idiopathic parkinsonism in that the former has unique clinical features and a normal fluorodopa PET scan.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
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