Asunto(s)
Intoxicación del Sistema Nervioso por Mercurio/terapia , Estimulación Magnética Transcraneal , Temblor/terapia , Anciano de 80 o más Años , Enfermedad Crónica , Humanos , Masculino , Intoxicación del Sistema Nervioso por Mercurio/diagnóstico por imagen , Estimulación Magnética Transcraneal/métodos , Temblor/diagnóstico por imagenRESUMEN
The Minamata disease was discovered in the Minamata region, Kumamoto Prefecture, Japan, in 1956. Symptoms of this disease included cerebellar ataxia, sensory disturbance, narrowing of the visual field, and hearing and speech disturbances. In 1965, similar conditions were identified in persons living around the Agano River area, Niigata Prefecture, Japan and accordingly termed as the Niigata Minamata disease or the second Minamata disease. Both the diseases have been attributed to poisoning with methyl mercury that was generated during the production of acetaldehyde using mercury as a catalyst. The discharged methyl mercury accumulated in fishes and shellfishes and caused poisoning on consumption. This review discusses the history, clinical presentation including atypical forms, and autopsy findings of the Niigata Minamata disease. In addition, it highlights the problems about criteria for official recognition and the therapeutic trial for this disease.
Asunto(s)
Intoxicación del Sistema Nervioso por Mercurio/diagnóstico , Intoxicación del Sistema Nervioso por Mercurio/terapia , Compuestos de Metilmercurio/toxicidad , Adulto , Autopsia , Progresión de la Enfermedad , Humanos , Japón , Masculino , Intoxicación del Sistema Nervioso por Mercurio/patología , Guías de Práctica Clínica como AsuntoRESUMEN
The authors present a case of accidental intrathecal mercury application. A 69-year-old white woman was admitted to our department with suspected meningitis following surgery for spinal stenosis at another hospital. Postoperatively, she had developed a cerebro-spinal fluid (CSF) fistula with a subcutaneous cavity. Local wound irritation had been suspected and, unfortunately, mercury-containing disinfectant was injected into the cavity. Within 24 h the patient demonstrated acute neurological deterioration due to meningitis and encephalitis and was admitted to our clinic with suspected meningitis due to postoperative CSF fistula. Lumbar puncture revealed desinfectant-stained, non-bloody CSF, while lumbar MRI demonstrated the large lumbar subcutaneous cavity. Additionally, CSF fistula was visualized on MRI. Laboratory examination revealed extremely high mercury levels in CSF, blood and urine. Treatment consisted in insertion of a lumbar drainage to wash out the mercury. The patient underwent medical detoxication using chelating agents (DMPS: RS-2,3-dimercapto-1-propansulfonacid, DMSA: meso-2,3-dimercaptosuccinatacid). Surgery was performed in order to close the cavity and the fistula. Postoperatively, the patient was admitted to the intensive care unit and remained intubated for 3 days. Within 4 weeks after surgery, she demonstrated good recovery. Eighteen months after intoxication, polyneuropathy and slight neuropsychological deficiencies were detectable.
Asunto(s)
Antiinfecciosos Locales/administración & dosificación , Fístula Cutánea/etiología , Duramadre , Inyecciones Espinales , Merbromina/administración & dosificación , Intoxicación del Sistema Nervioso por Mercurio/etiología , Procedimientos Ortopédicos/efectos adversos , Anciano , Líquido Cefalorraquídeo , Quelantes/uso terapéutico , Femenino , Humanos , Meningitis/etiología , Intoxicación del Sistema Nervioso por Mercurio/terapia , Estenosis Espinal/cirugía , Dehiscencia de la Herida Operatoria/etiología , Infección de la Herida Quirúrgica/etiología , Infección de la Herida Quirúrgica/terapia , Irrigación Terapéutica/métodosRESUMEN
Autism is a developmental disease characterized by a spectrum of symptoms ranging from decreased verbal skills and social withdrawal, to repetitive behavior and violent outbursts. Genetic analysis has yielded a few potentially interesting genes, however no clear linkage has been established. For this reason, it has been suggested that the etiology of autism may involve multiple loci. This, in large part, explains why so many different theories abound. One such theory is that of mercury poisoning. Environmentally acquired mercury, either through some causal contact or through vaccination, has been postulated as the culprit. Mercury is thought to be exerting its neurological effect on the brain. The standard treatment has been to apply chelating agents in an attempt to extricate the mercury. One missing component in the treatment is the utilization of the body's own detoxification mechanisms. Arguably the largest detoxification component of the body, the endogenous enteric bacteria are an enormous reservoir, which can be constantly and safely replenished. This paper discusses the use of high-dose probiotics as an adjuvant for detoxification protocols with an emphasis on use in autistics.
Asunto(s)
Trastorno Autístico/terapia , Inactivación Metabólica , Probióticos , Trastorno Autístico/etiología , Trastorno Autístico/metabolismo , Humanos , Intoxicación del Sistema Nervioso por Mercurio/complicaciones , Intoxicación del Sistema Nervioso por Mercurio/metabolismo , Intoxicación del Sistema Nervioso por Mercurio/terapia , Compuestos de Metilmercurio/farmacocinética , Compuestos de Metilmercurio/envenenamientoRESUMEN
Against the background of clinical symptoms of mercury poisonings a case of suicidal poisoning which had favourable course and prognosis was presented. The impact of toxic renal damage and different CNS symptoms was emphasised.
Asunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Intoxicación del Sistema Nervioso por Mercurio/diagnóstico , Población Rural , Adulto , Etanol/sangre , Humanos , Masculino , Mercurio/farmacocinética , Intoxicación del Sistema Nervioso por Mercurio/sangre , Intoxicación del Sistema Nervioso por Mercurio/terapia , Tasa de Depuración Metabólica/fisiología , Pronóstico , Intento de SuicidioRESUMEN
BACKGROUND: Mercury poisoning presents a variety of clinical pictures depending on chemical structure, amount absorbed, total mercury burden, and individual factors. Distant skin lesions, after subcutaneous injection of metallic mercury, have not been previously described. CASE REPORT: We present a homicidal, subcutaneous injection of mercury resulting in widespread skin lesions, remote from the radiologically visible mercury. The lesions appeared at 40 days and began to clear at 6 months after the injection.