Clinical features, electrophysiological characteristics and treatment of thallium poisoning in twelve patients / 中国神经精神疾病杂志

ABSTRACT

Objective To investigate the clinical and electrophysiological features and treatments for thallium poisoning. Methods Twelve cases of thallium poisoning patients were from hospital 307 of PLA between June 2012 and October 2017 and their data were retrospectively analyzed. Twelve sex-and age-matched healthy subjects were selected as control group. Result The clinical manifestations of thallium poisoning were mainly symptoms of nervous and gastrointestinal systems as well as hair loss. Thallium poisoning compromised function of motor nerves including the prolonged distal latency of ulnar and common peroneal nerve, the decreased amplitude and slowed nerve conduction velocity of common peroneal nerve and tibial nerve, which were statistically different from control group (P<0.05). Thallium poisoning also impaired function of sensory nerve including the prolonged distal latency and decreased amplitude of median , ulnar and sural nerve, the slowed nerve conduction velocity of median , ulnar, radial and sural nerve which were statistically different from control group (P<0.05 or P<0.01 ). Electroencephalogram (EEG) of 7 cases revealed mild abnormality EEG in 6 cases and moderate abnormality EEG in one case. Patients received potassium supplementation, diuresis, oral Prussian blue, intramuscular injection of sodium dimercaptopropanesulfonate and other treatment. Severe cases had good outcome after hemoperfusion and plasma exchange. Conclusions Thallium poisoning is rare in clinic and typical clinical features and electrophysiological examination are helpful to the diagnosis and differential diagnosis of diseases. Timely increasing thallium excretion and symptomatic support treatment can effectively improve the prognosis of the patients.