Seven cases of toxic encephalopathy associated with diquat poisoning / 中华急诊医学杂志

Objective:To improve the understanding of the clinical features of toxic encephalopathy associated with diquat poisoning.Methods:This study collected and analyzed the diagnosis and treatment process of 7 patients with acute diquat poisoning combined with central nervous system complications admitted to the First Affiliated Hospital of Zhengzhou University from April 2021 to April 2022. "Diquat" and "Poisoning" were used as keywords to search in CNKI, Wanfang database and PubMed database, and the literature of previous cases was reviewed for summary analysis.Results:Among the 7 patients in our hospital, there were 2 males and 5 females, with an average age of 31 years (range14-57) and an average dose of 23.14 g [(10-40)g]. During the treatment, 3 patients developed irritability and convulsions, 3 patients occurred coma, and one had generalized tonic-clonic seizures. Four patients died and 3 survived, of which 2 patients returned to normal life and study, and one remained abnormal mental behavior (currently in long-term follow-up). All three survivors developed neurological symptoms later than those who died, and were awake about 30 days after taking the drug.Conclusions:Toxic encephalopathy associated with diquat poisoning has rapid progression, poor prognosis and high mortality. This study found that the survival rate of patients with > 48 h of first onset of neurological symptoms is much higher than that of patients with ≤ 48 h of first onset of neurological symptoms, while sex, age, estimated oral dose, and type of presentation of neurological symptoms for the first time have little effect on the survival rate of hospital discharge. The earlier neurological symptoms appear, the greater the likelihood of a poor prognosis.

Central Pontine Myelinolysis Presenting With Cerebellar Ataxia

Central pontine myelinolysis (CPM) is a neurologic disorder that is usually related to rapid correction of hyponatremia and chronic alcoholism. CPM involves concentrated, symmetric, noninflammatory demyelination within the central pons; this pathology also occurs in extrapontine regions. Frequently observed clinical manifestations are sudden weakness, dysphagia, dysarthria, loss of consciousness, and locked-in syndrome. We describe herein a case of CPM predominated by cerebellar signs without typical symptoms, but with involvement of the cerebellum or cerebellar peduncle.

Central Pontine and Extrapontine Myelinolysis without Hyponatremia after Alcohol Withdrawal: One Case Report

Central pontine myelinolysis (CPM) is a demyelinating disorder that was first described by Adams et al. in 1959 in patients with a history of alcoholism and malnutrition. It is characterized by delirium, quadriparesis, pseudobulbar palsy, and dysarthria. A subgroup of patients at risk for CPM are chronic alcoholics, malnutrition, diabetes, liver transplantation, hepatic disease, advanced age. Although the cause and pathogenesis remains unclear, but many studies have implicated that the rapid correction of hyponatremia is the major factor associated with CPM. But CPM without hyponatremia has been rarely reported. Diagnosis is confirmed by MR image. Here we present one case of CPM without electrolyte disturbance after alcohol withdrawal in a chronic alcoholic with literature reviews.

Analysis of 4 cases with central pontine myelinolysis and extral pontine myelinolysis / 中国康复理论与实践

@#ObjectiveTo explore the pathogeny, diagnosis and rehabilitation of central pontine myelinolysis.MethodsClinical data of four patients with central potine myelinolysis were studied retrospectively.ResultsAll of them had pseudobulbar palsy and dystonia; three had coma; two had history of hyposodemia ameliorated rapidly, one had history of hypersodemia ameliorated rapidly. All of them had focuses in pons; three had focuses beyond pons. All patients had good prognoses.ConclusionHistory of hyposodemia ameliorated rapidly is a usual pathogeny of central potine myelinolysis, integrative measures of rehabilitation can improve prognosis and quality of daily life.