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Author Md, Kanokrat Suwanlaong ♦ Md, Kammant Phanthumchinda
Source CiteSeerX
Content type Text
File Format PDF
Subject Domain (in DDC) Computer science, information & general works ♦ Data processing & computer science
Subject Keyword Methyl Bromide Intoxication ♦ Neurological Manifestation ♦ Methyl Bromide ♦ Chronic Exposure ♦ Permanent Brain Damage ♦ Methyl Bromide Fumigation ♦ Bilateral Dentate Nucleus ♦ Abdominal Pain ♦ Neuropsychiatric Disturbance ♦ Unstable Gait ♦ Fourteen Co-worker ♦ Electrophysilogical Study ♦ Fluid-attenuation Inversion Recovery ♦ Periventricular Area ♦ Toxic Gas ♦ Cerebellar Sign ♦ Ataxic Gait ♦ Cerebellar Dysfunction ♦ First Case ♦ Acute Toxicity ♦ Dry Foodstuff ♦ Worker Education ♦ Bilateral Symmetrical Lesion ♦ Mg Dl ♦ Poor Olfactory Warning Property ♦ Peripheral Nervous System ♦ Visual Disturbance ♦ Hyperactive Reflex ♦ Safety Precaution ♦ Vibratory Sense ♦ Neurological Examination ♦ Severe Poisoning ♦ Fourth Ventricle ♦ Abnormal Hypersignal Intensity ♦ Magnetic Resonance Imaging ♦ 24-year-old Man ♦ Serum Concentration ♦ Insecticidal Fumigant
Abstract Methyl 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, un-consciousness 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.
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Research
Education Level UG and PG ♦ Career/Technical Study