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Toxins and the Nervous System

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Emergencies in Neurology

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Abstract

Acute poisoning can result in a medical emergency and account for up to 10% of admissions into hospital. It is an important cause of morbidity and mortality in India. Generally, the effects of toxins manifest in several systems in the body, including the skin, mucus membrane, the haematopoietic, hepatic, renal and nervous systems. The neurological manifestations may involve different regions and fibre tracts of the central and peripheral nervous systems. This chapter predominantly describes the effects of toxins on the nervous system.

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References

  1. Espinoza EO, Ann MJ, Bleasdell B. Arsenic and mercury in traditional Chinese herbal balls. N Engl J Med. 1995;333:803–4.

    Article  CAS  Google Scholar 

  2. Steingass A. A comprehensive Persian English dictionary. London: Kegan Paul, Trench, Trubner and Company; 1947.

    Google Scholar 

  3. Vahidnia A, van der Voet GB, de Wolff FA. Arsenic neurotoxicity—a review. Hum Exp Toxicol. 2007;26:823–32.

    Article  CAS  Google Scholar 

  4. De Wolff FA, Edelbroek PM. Neurotoxicity of arsenic and its compounds. In: Vinken DJ, Bruyn GW, editors. Handbook of clinical neurology. Amsterdam: Elsevier; 1994. p. 283–91.

    Google Scholar 

  5. Nickson R, McArthur J, Burgess W, et al. Arsenic poisoning of Bangladesh groundwater. Nature. 1998;395:338–9.

    Article  CAS  Google Scholar 

  6. Ratnaike RN. Acute and chronic arsenic toxicity. Postgrad Med J. 2003;79:391–6.

    Article  CAS  Google Scholar 

  7. Jing Y, Wang L, Xia L, et al. Combined effect of all-trans retinoic acid and arsenic trioxide in acute promyelocytic leukaemia cells in vitro and in vivo. Blood. 2001;97:264–9.

    Article  CAS  Google Scholar 

  8. Kingston RL, Hall S, Sioris L. Clinical observations and medical outcomes in 149 cases of arsenate ant killer ingestion. J Toxicol Clin Toxicol. 1993;31:581–91.

    Article  CAS  Google Scholar 

  9. Schoolmeester WL, White DR. Arsenic poisoning. South Med J. 1980;73:198–208.

    Article  CAS  Google Scholar 

  10. Chhuttani PN, Chopra JS. Arsenic poisoning. In: Vinken DJ, Bruyn GW, editors. Intoxication of the nervous system. Handbook of clinical neurology, vol. 36. Amsterdam: North-Holland/Elsevier; 1979. p. 199–216.

    Google Scholar 

  11. Ghariani M, Adrien ML, Raucoules M, et al. Subacute arsenic poisoning. Ann Fr Anesth Reanim. 1991;10:304–7.

    Article  CAS  Google Scholar 

  12. Vantroyen B, Heilier JF, Meulemans A, et al. Survival after a lethal dose of arsenic trioxide. J Toxicol Clin Toxicol. 2004;42:889–95.

    Article  CAS  Google Scholar 

  13. Perriol MP, Devos D, Hurtevent JF, et al. A case of neuropathy mimicking Guillain–Barré syndrome after arsenic intoxication. Rev Neurol. 2006;162:374–7.

    Article  Google Scholar 

  14. Moore D, House I, Dixon A. Thallium poisoning: diagnosis may be elusive but alopecia is the clue. BMJ. 1993;306:1527–9.

    Article  CAS  Google Scholar 

  15. Tromme I, Van Neste D, Dobbelaere F, et al. Skin signs in the diagnosis of thallium poisoning. Br J Dermatol. 1998;138:321–5.

    Article  CAS  Google Scholar 

  16. Pau PWI. Management of thallium poisoning. Hong Kong Med J. 2000;6:316–8.

    CAS  PubMed  Google Scholar 

  17. Atsmon J, Taliansky E, Landau M, et al. Thallium poisoning in Israel. Am J Med Sci. 2000;320:327–30.

    Article  CAS  Google Scholar 

  18. Prick JJG. Thallium poisoning. In: Vinken DJ, Bruyn GW, editors. Intoxication of the nervous system. Handbook of clinical neurology, vol. 36. Amsterdam: North-Holland; 1979. p. 239–78.

    Google Scholar 

  19. McMillan TM, Jacobson RR, Gross M. Neuropsychology of thallium poisoning. J Neurol Neurosurg Psychiatry. 1997;63:247–50.

    Article  CAS  Google Scholar 

  20. Van Kesteren RG. Thallium. In: Vinken DJ, Bruyn GW, de Wolff FA, editors. Intoxication of the nervous system. Handbook of clinical neurology, vol. 64. Amsterdam: North-Holland; 1994. p. 322–9.

    Google Scholar 

  21. Tsai YT, Huang CC, Kuo HC, et al. Central nervous system effects in acute thallium poisoning. Neurotoxicology. 2006;27:291–5.

    Article  CAS  Google Scholar 

  22. Misra UK, Kalita J, Yadav RK, et al. Thallium poisoning: emphasis on early diagnosis and response to haemodialysis. Postgrad Med J. 2003;79:103–5.

    Article  CAS  Google Scholar 

  23. Lu CI, Huang CC, Chang YC, et al. Shortterm thallium intoxication: dermatological findings correlated with thallium concentration. Arch Dermatol. 2007;143:93–8.

    CAS  PubMed  Google Scholar 

  24. Vrij AA, Cremers HM, Lustermans FA. Successful recovery of a patient with thallium poisoning. Neth J Med. 1995;47:121–6.

    Article  CAS  Google Scholar 

  25. Jayarathnam J. Pesticide poisoning as a global health problem. World Health Stat Q. 1990;43:139–44.

    Google Scholar 

  26. Siwach SB, Gupta A. The profile of acute poisonings in Harayana-Rohtak study. J Assoc Physicians India. 1995;43:756–9.

    CAS  PubMed  Google Scholar 

  27. Malik GM, Mubarik M, Romshoo GJ. Organophosphorus poisoning in the Kashmir Valley, 1994 to 1997. N Engl J Med. 1998;338:1078.

    Article  CAS  Google Scholar 

  28. Karalliedde L. Organophosphorus poisoning and anaesthesia. Anaesthesia. 1999;54:1073–88.

    Article  CAS  Google Scholar 

  29. Besser R, Vogt T, Gutmann L, et al. High pancuronium sensitivity of axonal nicotinic–acetylcholine receptors in humans during organophosphate intoxication. Muscle Nerve. 1991;14:1197–201.

    Article  CAS  Google Scholar 

  30. Baker DJ, Sedgwick EM. Single fibre electromyographic changes in man after organophosphate exposure. Hum Exp Toxicol. 1996;15:369–75.

    Article  CAS  Google Scholar 

  31. Senanayake N, Karalliedde L. Neurotoxic effects of organophosphorus insecticides: an intermediate syndrome. N Engl J Med. 1987;316:761–3.

    Article  CAS  Google Scholar 

  32. Leon-S FE, Pradilla G, Vesga E. Neurological effects of organophosphate pesticides. BMJ. 1996;313:690–1.

    Article  CAS  Google Scholar 

  33. Tafuri J, Roberts J. Organophosphate poisoning. Ann Emerg Med. 1987;16:193–202.

    Article  CAS  Google Scholar 

  34. de Silva HJ, Wijewickrema R, Senanayake N. Does pralidoxime affect outcome of management in acute organophosphorus poisoning? Lancet. 1992;339:1136–8.

    Article  Google Scholar 

  35. Yang CC, Deng JF. Intermediate syndrome following organophosphate insecticide poisoning. J Chin Med Assoc. 2007;70:467–72.

    Article  CAS  Google Scholar 

  36. Korabathina K, Benbadis SR, Likosky D. Methanol [eMedicine website]. Available from: www.emedicine.com/neuro/topic217.htm. Accessed 4 Nov 2008.

  37. Paasma R, Hovda KE, Tikkerberi A, et al. Methanol mass poisoning in Estonia: outbreak in 154 patients. Clin Toxicol. 2007;45:152–7.

    Article  CAS  Google Scholar 

  38. Brent J, Lucas M, Kulig K, et al. Methanol poisoning in a 6-week-old infant. J Pediatr. 1991;118:644–6.

    Article  CAS  Google Scholar 

  39. Barceloux DG, Bond GR, Krenzelok EP, Cooper H, Vale JA, American Academy of Clinical Toxicology Ad Hoc Committee on the Treatment Guidelines for Methanol Poisoning. American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning. J Toxicol Clin Toxicol. 2002;40:415–46.

    Article  CAS  Google Scholar 

  40. Bennett JL, Cary FH, Mitchell GL, et al. Acute methyl alcohol poisoning: a review based on experiences in an outbreak of 323 cases. Medicine. 1953;32:431–63.

    Article  Google Scholar 

  41. Hovda KE, Hunderi OH, Tafjord AB, et al. Methanol outbreak in Norway 2002–2004. Epidemiology, clinical features and prognostic signs. J Intern Med. 2005;258:181–90.

    Article  CAS  Google Scholar 

  42. Liu JJ, Daya MR, Carrasquillo O, et al. Prognostic factors in patients with methanol poisoning. J Toxicol Clin Toxicol. 1999;36:175–80.

    Article  Google Scholar 

  43. Kraut JA, Kurtz I. Use of base in the treatment of severe acidemic states. Am J Kidney Dis. 2001;38:703–27.

    Article  CAS  Google Scholar 

  44. McMartin KE, Ambre JJ, Tephly TR. Methanol poisoning in human subjects. Role for formic acid accumulation in the metabolic acidosis. Am J Med. 1980;68:414–8.

    Article  CAS  Google Scholar 

  45. Tephly TR. The toxicity of methanol. Life Sci. 1991;48:1031–41.

    Article  CAS  Google Scholar 

  46. Chu J, Wang RY, Hill NS. Update in clinical toxicology. Am J Respir Crit Care Med. 2002;166:9–15.

    Article  Google Scholar 

  47. Brent J, McMartin K, Phillips S, et al. Fomepizole for the treatment of methanol poisoning. N Engl J Med. 2001;344:424–9.

    Article  CAS  Google Scholar 

  48. Megarbane B, Borron SW, Baud FJ. Current recommendations for treatment of severe toxic alcohol poisonings. Intensive Care Med. 2005;31:189–95.

    Article  Google Scholar 

  49. Megarbane B, Borron SW, Trout H, et al. Treatment of acute methanol poisoning with fomepizole. Intensive Care Med. 2001;27:1370–8.

    Article  CAS  Google Scholar 

  50. Hovda KE, Froyshov S, Gudmundsdottir H, et al. Fomepizole may change indication for hemodialysis in methanol poisoning: prospective study in seven cases. Clin Nephrol. 2005;64:190–7.

    Article  CAS  Google Scholar 

  51. World Health Organization. Progress in the characterization of the venoms and the standardization of the antivenoms, vol. 58. Geneva: World Health Organization; 1981. p. 1–44.

    Google Scholar 

  52. Warrell DA and International Panel of Experts. WHO/SEARO guidelines for the clinical management of snake bites in the Southeast Asian region. Southeast Asian J Trop Med Public Health. 1999;30(Suppl 1):1–85.

    Google Scholar 

  53. Lewis RL, Gutmann L. Snake venoms and the neuromuscular junction. Semin Neurol. 2004;24:175–9.

    Article  Google Scholar 

  54. Bawaskar HS, Bawaskar PH. Profile of snakebite envenoming in western Maharashtra, India. Trans R Soc Trop Med Hyg. 2002;96:79–84.

    Article  CAS  Google Scholar 

  55. Rivière G, Choumet V, Audebert F, et al. Effect of antivenom on venom pharmacokinetics in experimentally envenomed rabbits: toward an optimization of antivenom therapy. J Pharmacol Exp Ther. 1997;281:1–8.

    PubMed  Google Scholar 

  56. Warrell DA. Animal toxins. In: Cook GC, Zumla A, editors. Manson’s tropical diseases. London: WB Saunders; 2003. p. 581–618.

    Google Scholar 

  57. Bawaskar HS. Snake venom and antivenom: critical supply issues. J Assoc Physicians India. 2004;52:11–3.

    CAS  PubMed  Google Scholar 

  58. Agarwal R, Aggarwal AN, Gupta D, et al. Low dose of snake antivenom is as effective as high dose in patients with severe neurotoxic snake envenoming. Emerg Med J. 2005;22:397–9.

    Article  CAS  Google Scholar 

  59. Geller T, Loftis L, Brink DS. Cerebellar infarction in adolescent males associated with acute marijuana use. Pediatrics. 2004;113:e365–70.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Additional Professor, Department of Neurology, JIPMER, Puducherry, India

    Pradeep P. Nair

  2. Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

    Jayantee Kalita & Usha K. Misra

Authors
  1. Pradeep P. Nair
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  2. Jayantee Kalita
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  3. Usha K. Misra
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Editor information

Editors and Affiliations

  1. Department of Neurology, All India Institute of Medical Sciences, New Delhi, India

    Mamta Bhushan Singh

  2. Department of Neurology, All India Institute of Medical Sciences, New Delhi, India

    Rohit Bhatia

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Nair, P.P., Kalita, J., Misra, U.K. (2019). Toxins and the Nervous System. In: Singh, M., Bhatia, R. (eds) Emergencies in Neurology . Springer, Singapore. https://doi.org/10.1007/978-981-13-7381-7_12

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  • DOI: https://doi.org/10.1007/978-981-13-7381-7_12

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