Neurological manifestation of methyl bromide intoxication.

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dc.contributor.authorSuwanlaong, Kanokraten_US
dc.contributor.authorPhanthumchinda, Kammanten_US
dc.date.accessioned2009-05-27T21:41:49Z
dc.date.available2009-05-27T21:41:49Z
dc.date.issued2008-03-26en_US
dc.descriptionChotmaihet Thangphaet.en_US
dc.description.abstractMethyl bromide is a highly toxic gas with poor olfactory warning properties. It is widely used as insecticidal fumigant for dry foodstuffs and can be toxic to central and peripheral nervous systems. Most neurological manifestations of methyl bromide intoxication occur from inhalation. Acute toxicity characterized by headache, dizziness, abdominal pain, nausea, vomiting and visual disturbances. Tremor, convulsion, unconsciousness and permanent brain damage may occur in severe poisoning. Chronic exposure can cause neuropathy, pyramidal and cerebellar dysfunction, as well as neuropsychiatric disturbances. The first case of methyl bromide intoxication in Thailand has been described. The patient was a 24-year-old man who worked in a warehouse of imported vegetables fumigated with methyl bromide. He presented with unstable gait, vertigo and paresthesia of both feet, for two weeks. He had a history of chronic exposure to methyl bromide for three years. His fourteen co-workers also developed the same symptoms but less in severity. Neurological examination revealed ataxic gait, decreased pain and vibratory sense on both feet, impaired cerebellar signs and hyperactive reflex in all extremities. The serum concentration of methyl bromide was 8.18 mg/dl. Electrophysilogical study was normal. Magnetic resonance imaging of the brain (MRI) revealed bilateral symmetrical lesion of abnormal hypersignal intensity on T2 and fluid-attenuation inversion recovery (FLAIR) sequences at bilateral dentate nuclei of cerebellum and periventricular area of the fourth ventricle. This incident stresses the need for improvement of worker education and safety precautions during all stages of methyl bromide fumigation.en_US
dc.description.affiliationDivision of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.en_US
dc.identifier.citationSuwanlaong K, Phanthumchinda K. Neurological manifestation of methyl bromide intoxication. Journal of the Medical Association of Thailand. 2008 Mar; 91(3): 421-6en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/45243
dc.language.isoengen_US
dc.source.urihttps://www.mat.or.th/journal/all.phpen_US
dc.subject.meshAdulten_US
dc.subject.meshBrain Diseases --etiologyen_US
dc.subject.meshBrain Stemen_US
dc.subject.meshCerebellar Diseases --diagnosisen_US
dc.subject.meshHumansen_US
dc.subject.meshHydrocarbons, Brominated --toxicityen_US
dc.subject.meshMaleen_US
dc.subject.meshNoxae --toxicityen_US
dc.subject.meshOccupational Exposure --adverse effectsen_US
dc.subject.meshParesthesia --etiologyen_US
dc.titleNeurological manifestation of methyl bromide intoxication.en_US
dc.typeCase Reportsen_US
dc.typeJournal Articleen_US
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