In this paper, the MRI manifestations of 15 patients with benzene toxic encephalopathy were analyzed, and the lesion location, shape, scope and signal were observed. The clinical manifestations of 15 patients were mainly central nervous system damage, and the MRI manifestations were characteristic, with a wide range of lesions, and the shapes were "sunflower-like", "flame-like", "bracket-like" and "butterfly-like", and the MRI signal was sheet-like long T(1), long T(2), fluid attenuated inversion recovery (FLAIR) sequence and diffusion weighted imaging (DWI) high signal, apparent diffusion coeffecient (ADC) map low, equal or high signals. When the patient's diagnosis is unclear, MRI examination may provide clinical basis for diagnosis.
Benzene ; Diffusion Magnetic Resonance Imaging/methods* ; Humans ; Magnetic Resonance Imaging ; Neurotoxicity Syndromes/etiology*

Objective: To investigate the implementation of Diagnostic Criteria of Occupational Acute Neurotoxic Diseases Caused by Chemicals (GBZ 76-2002) for accumulating basis of standard revision. Methods: In February 2020, 85 experts in occupational diseases and neurology from 39 medical and health institutions were selected as the respondents. The modified Delphi method was used to establish the standard evaluation index system and special group was organized for discussing the pre-survey and completing the questionnaire survey. Questionnaire survey was performed to investigate the grasp of the standards, application and modification suggestions of respondents. Results: The respondents' mastery of standard-related knowledge mainly came from work experience (84.7%, 72/85) , standard learning (81.2%, 69/85) and training (75.3%, 64/85) . Among the institutions in which the respondents worked, 98.8% (84/85) could carry out CT examinations, 96.5% (82/85) could carry out nerve conduction velocity and electromyography examinations, 89.4% (76/85) could carry out EEG examinations, 80% (68/85) could carry out evoked potential examinations and 72.9% (62/85) could carry out MRI examinations. Among the toxicants diagnosed as occupational acute toxic myelopathy, 10.6% (9/85) were organic phosphorus and 9.4% (8/85) were asphyxiating gas; Among the toxicants diagnosed as delayed peripheral neuropathy, pesticides accounted for 25.9% (22/85) and asphyxiating gases accounted for 12.9% (11/85) . 85.9% (73/85) of the respondents believed that the basis for the classification of acute toxic encephalopathy needed to supplement objective evidence; 80.0% (68/85) of the respondents thought that the diagnosis and classification of peripheral neuropathy should be refined according to the abnormal indexes of neuroelectromyography. Conclusion: The applicability of the criteria needs to be improved because the current criteria has a long application cycle without enough objective investigation bases in classification criteria index.
Humans ; Occupational Exposure/adverse effects* ; Occupational Diseases/diagnosis* ; Hazardous Substances ; Neurotoxicity Syndromes/diagnosis* ; Peripheral Nervous System Diseases

Objective: To explore the CT and MRI imaging findings of diquat toxic encephalopathy. Methods: CT and MRI imaging features of 10 patients with diquat poisoning encephalopathy who had been clinically diagnosed were retrospectively reviewed. Results: CT was performed in all 10 patients, and MRI was performed in 8 patients. In 10 patients, 7 had positive signs on CT, and 8 patients with MRI examination had abnormal changes in the images. The main CT findings were symmetrical hypodensity in bilateral cerebellar hemisphere, brainstem, thalamus and basal ganglia, and swelling of brain tissue. The main MRI findings were symmetrical lesions and brain edema in the deep nuclei of cerebellar hemisphere, brainstem, thalamus and basal ganglia, low signal on T1WI, high signal on T2WI and T2-FLAIR, and cytotoxic edema on diffusion weighted imaging (DWI) . On review after treatment, both CT and MRI showed resorption of the lesion, which narrowed in size. Conclusion: The imaging findings of diquat poisoning encephalopathy are characteristic and the location of the lesion is characteristic, and CT and MRI have a certain diagnostic value in diquat poisoning encephalopathy, which is important for clinical treatment.
Brain Diseases ; Diffusion Magnetic Resonance Imaging/methods* ; Diquat ; Humans ; Magnetic Resonance Imaging/methods* ; Neurotoxicity Syndromes/etiology* ; Retrospective Studies

BACKGROUND: Although lead neurotoxicity is a known phenomenon, it can often be missed at a primary or secondary care level especially if detailed environmental exposure history is missed. METHODS: This is an outbreak investigation where we observed 15 pediatric cases with neurologic signs and symptoms clustered in a slum area known for an unorganized artificial jewelry industry. Their clinical, biochemical, and epidemiological features were compared with 14 other children from the same region reporting with non-neurological symptoms who were considered as unmatched controls. RESULTS: Cases with neurological manifestations had a higher in-house lead smelting activity [OR 7.2 (95% CI 1.4-38.3)] as compared to controls. Toddlers below 3 years of age were more vulnerable to the effects of lead. CONCLUSION This study emphasizes that many focal sources of lead poisoning still remain especially in the unorganized sector. In cases presenting with unexplained neurotoxicity, specific occupational and environmental inquiry for chemical poisoning, with special consideration for lead, should be actively pursued.
Adolescent ; Air Pollution, Indoor ; adverse effects ; Case-Control Studies ; Child ; Child, Preschool ; Disease Outbreaks ; Female ; Humans ; India ; epidemiology ; Infant ; Inhalation Exposure ; adverse effects ; Jewelry ; poisoning ; Lead ; blood ; standards ; Lead Poisoning ; epidemiology ; pathology ; physiopathology ; Male ; Metallurgy ; Neurotoxicity Syndromes ; epidemiology ; pathology ; physiopathology ; Poverty Areas ; Risk Factors

Sugammadex provides fast and safe recovery from neuromuscular blockade without causing major adverse effects, and its clinical use is increasing. However, there are some reports on the potential risks of sugammadex, such as severe bradycardia, interactions with steroids, coagulopathy, and neuronal damage. Although these potential risks are not clearly proven, they are considered to be dose-dependent and occur more frequently with the free-form of sugammadex. Until further pieces of evidence are accumulated, it is prudent to be aware of these potential risks and avoid an overdose of sugammadex.
Blood Coagulation Disorders ; Bradycardia ; Drug Interactions ; Neuromuscular Blockade ; Neurons ; Neurotoxicity Syndromes ; Steroids

Along with the field of adult psychiatry, antipsychotic agents are increasingly used in the field of child and adolescent psychiatry. Although neuroleptic malignant syndrome (NMS) and rhabdomyolysis are rare complication associated with antipsychotic agent, clinicians should need to pay attention to all potential adverse drug reaction (ADR). Also, ADRs in child and adolescent could show different signs and symptoms compared with those in adult. In this case report, we present a case of NMS in a child which occurred shortly after the resolution of rhabdomyolysis which was induced by low-dose risperidone.
Adolescent Psychiatry ; Adolescent ; Adult ; Antipsychotic Agents ; Child ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Neuroleptic Malignant Syndrome ; Rhabdomyolysis ; Risperidone

Dioscorea tokoro has long been used in Korean traditional medicine as a pain killer and anti-inflammatory agent. A 53-year-old male who consumed water that had been boiled with raw tubers of D. tokoro as tea presented with numbness and spasm of both hands and feet. Laboratory results showed hypocalcemia, hypoparathyroidism, and vitamin D insufficiency. During his hospital stay, colitis, acute kidney injury, and toxic encephalopathy developed. The patient received calcium gluconate intravenous infusion and oral calcium carbonate with alfacalcidol. His symptoms improved gradually, but hypocalcemia persisted despite the calcium supplementation. We suggest that ingestion of inappropriately prepared D. tokoro can cause symptomatic hypocalcemia in patients with unbalanced calcium homeostasis.
Acute Kidney Injury ; Calcium ; Calcium Carbonate ; Calcium Gluconate ; Colitis ; Dioscorea ; Eating ; Foot ; Hand ; Homeostasis ; Humans ; Hypesthesia ; Hypocalcemia ; Hypoparathyroidism ; Infusions, Intravenous ; Length of Stay ; Male ; Medicine, Korean Traditional ; Middle Aged ; Neurotoxicity Syndromes ; Spasm ; Tea ; Vitamin D ; Water

As an environmental risk factor, psychological stress may trigger the onset or accelerate the progression of Parkinson's disease (PD). Here, we evaluated the effects of acute restraint stress on striatal dopaminergic terminals and the brain metabolism of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), which has been widely used for creating a mouse model of PD. Exposure to 2 h of restraint stress immediately after injection of a low dose of MPTP caused a severe loss of striatal dopaminergic terminals as indicated by decreases in the dopamine transporter protein and dopamine levels compared with MPTP administration alone. Both striatal 1-methyl-4-phenylpyridinium ion (MPP) and MPTP concentrations were significantly increased by the application of restraint stress. Striatal monoamine oxidase-B, which catalyzes the oxidation of MPTP to MPP, was not changed by the restraint stress. Our results indicate that the enhanced striatal dopaminergic terminal loss in the stressed mice is associated with an increase in the transport of neurotoxin into the brain.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine ; metabolism ; 1-Methyl-4-phenylpyridinium ; metabolism ; Animals ; Corpus Striatum ; drug effects ; metabolism ; Disease Models, Animal ; Dopaminergic Neurons ; drug effects ; MPTP Poisoning ; chemically induced ; metabolism ; Male ; Mice ; Mice, Inbred C57BL ; Neurotoxins ; metabolism ; Restraint, Physical ; Stress, Psychological ; metabolism

Decabromodiphenylethane (DBDPE) has been widely used as an alternative flame retardant due to the restriction or phase-out of traditional polybrominated diphenyl ethers (PBDEs), and is of increasing concern regarding its ubiquity, persistence, and potential adverse effects. In the present study, the toxicological effects of DBDPE were evaluated using zebrafish as an in vivo model. Upon being exposed to DBDPE-polluted sediments for a short term, it was found that the mortality and malformation of zebrafish (including edema, bent notochord, and bent tail) were not affected even at the highest concentration tested (1000.0 µg/kg dry sediment). Regarding behavioral responses, it was found that zebrafish larvae of 48 hours post fertilization (hpf) in all groups escaped successfully with a touch to the dorsal fin. However, when exposed to the highest DBDPE concentration, the larvae of 120 hpf exhibited significantly smaller distances as compared to the control. Moreover, the results of the acetylcholinesterase (AChE) activity, the expression levels of two important nerve-related genes, and the cell apoptosis all indicated that DBDPE posed low neurotoxicity in embryo-larval zebrafish. The results in this study shed some light on the potential risks of DBDPE in the real environment and highlight the application of the sediment exposure route in the future.
Abnormalities, Drug-Induced ; etiology ; Animals ; Apoptosis ; drug effects ; Behavior, Animal ; drug effects ; Bromobenzenes ; toxicity ; Geologic Sediments ; analysis ; Larva ; drug effects ; Neurotoxicity Syndromes ; etiology ; Water Pollutants, Chemical ; toxicity ; Zebrafish ; embryology

Metronidazole is an antimicrobial agent widely used for the treatment of anaerobic infection or antibiotics-associated diarrhea. It is generally thought to be safe, but can induce reversible toxic encephalopathy in the case of excessive or cumulative over-dose. Metronidazole-induced encephalopathy generally demonstrates the characteristic features of typical lesion location and bilaterality on magnetic resonance imaging (MRI). We report a case of metronidazole-induced encephalopathy with the involvement of asymmetric white matter. To our knowledge, only a few cases have been reported with respect to white matter lesion characteristics on MRI with diffusion-weighted images.
Brain Diseases ; Brain ; Diarrhea ; Magnetic Resonance Imaging ; Metronidazole ; Neurotoxicity Syndromes ; White Matter