Monomelic Amyotrophy after Permethrin Poisoning.
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Date
2015
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Abstract
Monomelic amyotrophy (MMA) known as Hirayama disease (HD). The first report appeared in 1959
when Hirayama described 12 patients [1] then, a large group of patients was found from Japan
[2,3]. MMA from South India was also reported in 1984 [4]. The disease accounted for males over
80% of cases, especially between 15 and 25 years of age. The disorder has been recognized as,
unilateral or bilateral asymmetric atrophy of hand and forearm with sparing of brachioradialis giving
the characteristic appearance of oblique amyotrophy. Symmetrically bilateral disease has also
been recognized. It is believed to be a cervical flexion myelopathy [5].
Pyrethroids are used as insecticides due to their high potency. These are highly toxic to a wide
range of insects but have low toxicity to humans. Pyrethroids are known to cause neurotoxicity in
humans like seizures, tremors, and dizziness. Motor neuron damage has been reported in acute
toxicity due to ingestion of pyrethroids and organochlorines [6] and MND (Motor neuron disease)
like features after chronic exposure has been reported [7]. Here a case of monomelic amyotrophy
following massive ingestion of permethrin, amytriptyline and benzodiazepine tablets is reported.
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Keywords
Monomelic amyotrophy, Hirayama disease, permethrin, Motor neuron disease
Citation
Kumar Dash Sandip. Monomelic Amyotrophy after Permethrin Poisoning. British Journal of Medicine and Medical Research. 2015; 5(2): 286-288.