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- A Sensorimotor Polyneuropathy Caused by Chronic Phenytoin Therapy
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Dong-Chul Han, Hyeon-Mi Park, Dong-Jin Shin, Yeong-Bae Lee
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J Korean Soc Clin Toxicol. 2006;4(2):128-130. Published online December 31, 2006
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Abstract
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- Phenytoin has been used globally as an effective anticonvulsant. Among its adverse effects, peripheral neuropathy including polyneuropathy has sometimes been reported. We report a case of sensorimotor polyneuropathy associated with high serum level and long-term phenytoin therapy. A 29-year-old male presented with motor weakness in all extremities. He was treated with phenytoin (400 mg/day) for about eight years because of generalized tonic clonic seizure. During none conduction assessment, sensorimotor polyneuropathy was discovered.
- A Case of Organophosphate Insecticide Intoxication by Repetitive Parenteral Exposure, Complicated with Intermediate Syndrome and Acute Pancreatitis
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Se-Hyun Oh, Hui-Dong Kang, Boo-Soo Lee
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J Korean Soc Clin Toxicol. 2006;4(2):161-165. Published online December 31, 2006
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Abstract
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- Organophosphate insecticides, commonly used in agriculture, are a gradually increasing cause of accidental and suicidal poisoning. Intoxication can occur by ingestion, inhalation or dermal contact. Exposure to organophosphorus agents causes a sequentially triphasic illness consisting of the cholinergic phase, the intermediate syndrome, and organophosphate-induced delayed polyneuropathy. Acute pancreatitis as a rare complication of organophosphate intoxication has also been infrequently observed. We report a case of intoxication with organophosphate (phos-phamidon) by parenteral exposure (inhalation and/or dermal contact). A 34-year-old male patient was transferred to our Emergency Medical Center and was intubated due to a progressive respiratory failure. He presented with meiotic pupils, cranial nerve palsies, weak respiration, and proximal limb motor weaknesses without sensory changes. He had been employed in filling syringes with phosphamidon during the previous month. Because the patient's history and symptoms suggested organophosphate intoxication with intermediate syndrome, he was mechanically ventilated for 18 days with continuous infusion of atropine and pralidoxime (total amounts of 159 mg and 216 g, respectively). During his admission, hyperamylasemia and hyperli-pasemia were detected, and his abdominal CT scan showed a finding compatible with acute pancreatitis. He was administered a conservative treatment with NPO and nasogastric drainage. The patient was discharged and showed neither gastrointestinal nor neurologic sequelae upon follow up at one week and three months.
- Peripheral Neuropathy after Inhalation of Mercury
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Hong Jae Chae, Hyoung Jai Lee, Sei Won Oh, Sung Kwan Lee, Jai-Dong Moon
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J Korean Soc Clin Toxicol. 2004;2(1):20-22. Published online June 30, 2004
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- Acute mercury inhalation poisoning is a rare cause of acute peripheral neuropathy. A 44-year-old female inhaled the fume from heating mercury to treat her palmar dermatitis. For 4 days, this procedure was done for 2-3 minutes after each meal. She subsequently complained flu like symptoms, such as headache, toothache, myalgia and arthralgia. She was admitted for 9 days and then symptoms disappeared. About 3 weeks after exposure, both knee pain developed and then she could not walk. To treat mercury intoxication, she was referred to our hospital. At that time, initial laboratory data were within normal limits, but blood and urinary mercury level were 5.6 11$mu$g/dl, 132.8 $mu$g/L. After treatment with D-penicillamine for 7 days, blood and urinary mercury level were 3.9 1$mu$g/dl, 177.3 $mu$g/L. During the following 1 month, both leg symptoms remained. Nerve conduction studies were performed, both leg sensory nerve amplitude decreased. These findings were suggestive of peripheral polyneuropathy.
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Korean Society of Clinical Toxicology