Arsenic nervous system

Arsenic Nervous system effects 0.010 Geological, pesticide residues, industrial waste, smelter operations... 

Central nervous system Nicotine, strychnine, arsenic, halogenated hydrocarbons, organic phosphates, dinitro-phenols, fluoroacetate (1080)... 

If HL (C03-A010) is involved, then exposure of the skin will produce an immediate burning sensation, which may be quickly followed by reddening of the skin (erythema). In addition to other latent effects, casualties exposed to HL may also develop signs of systemic arsenic toxicity including diarrhea, damage to the liver, kidneys, nervous system, and the brain. 

Arsenic vesicants produce immediate pain. Tissue damage occurs within minutes of exposure but clinical effects may not appear for up to 24 hours. Some agents are rapidly absorbed through the skin. Extensive skin contamination may cause systemic damage to the liver, kidneys, nervous system, red blood cells, and the brain. 

Suggested Alternatives for Differential Diagnosis Anthrax, tetanus, rabies, meningitis, encephalitis, cerebral trypanosomiasis, piroplasmosis, theileriosis, listeriosis, parasitism poisoning by strychnine, lead, organophosphates, arsenic, and various plants that affect the central nervous system. 

Soluble inorganic arsenic is acutely toxic, and ingestion of large doses leads to gastrointestinal symptoms, disturbances of cardiovascular and nervous system functions, and eventually death. In survivors, bone marrow depression, haemolysis, hepatomegaly, melanosis, polyneuropathy, and encephalopathy may be observed. 

SYMPTOMS - Painful vomiting and diarrhea, after a delay of up to an hour or so, eventual collapse of the central nervous system. Ingestion of a large quantity of arsenic, which is rapidly absorbed, and especially if alcohol is also consumed, produces paralytic poisoning the most dangerous form of arsenic intoxication. This causes depression of the CNS and quick death. Caution should be used as large doses may cause vomiting before it can be absorbed. 

Chemically, arsenic is complex in that it can exist in a variety of forms including trivalent and pentavalent or as arsenic trioxide (computer chip manufacture) and arsenic acid. Arsenic is excreted in skin cells, sweat, hair, and fingernails, which can be seen as white transverse bands. Acute exposure to arsenic results in gastrointestinal pain, sensory loss, cardiovascular failure, and death. Chronic exposure or survival of acute exposure can cause loss of peripheral sensory function and loss of central nervous system function. Chronic arsenic exposure can also cause cancer of the lung and skin (see the chapter on arsenic). 

Melarsoprol is a trivalent arsenical that has been available since 1949 and is first-line therapy for advanced central nervous system East African trypanosomiasis, and second-line therapy (after eflornithine) for advanced West African trypanosomiasis. 

When used in therapeutic doses, dimercaprol is associated with a high incidence of adverse effects, including hypertension, tachycardia, nausea, vomiting, lacrimation, salivation, fever (particularly in children), and pain at the injection site. Its use has also been associated with thrombocytopenia and increased prothrombin time—factors that may limit intramuscular injection because of the risk of hematoma formation at the injection site. Despite its protective effects in acutely intoxicated animals, dimercaprol may redistribute arsenic and mercury to the central nervous system, and it is not advocated for treatment of chronic poisoning. Water-soluble analogs of dimercaprol—unithiol and succimer—have higher therapeutic indices and have replaced dimercaprol in many settings. 

Chronic effects of arsenic poisoning include neurotoxic effects to the central and peripheral nervous systems. Symptoms include sensory changes, muscle sensitivity, prickling and tingling sensations (paresthesia), and muscle weakness. Liver injury is a common symptom of chronic arsenic poisoning. Studies of victims of chronic arsenic poisoning from contaminated drinking... 

Bismuth arsphenamine sulphonate (Bismarsen , Fig. 9) a yellow powder readily soluble in water, was first prepared by Raiziss in 1924 [70]. Stokes and Chambers [71] were the first to use the drug clinically, giving two injections a week for 14 weeks. Four such courses separated by intervals of a fortnight were administered in all. Nevertheless the effects were slow compared with the arsphenamines, although the tonic effect was greater and the side effects less numerous. Relapses, particularly in the central nervous system (CNS) were more frequent. Consequently, Rayburn and Boyd emphasized the fact that some individuals with neurosyphilis who were intolerant to arsenic in any other form could nevertheless tolerate it in the form of Bismarsen [72]. The low toxicity, the tonic effect, and the ease of administration were the chief advantages in favor of Bismarsen . The other compounds of bismuth with arsenic were not extensively tested in humans. 

Where did the lead come from and what effects did it have Lead is a cumulative poison. Like arsenic, it has many targets in the body and some of the symptoms of poisoning are easily confused with the symptoms of other diseases. Chronic, long-term lead exposure will cause effects on the nervous system which may become serious. The victim feels tired and listless, has constipation, is anaemic, and can become infertile. If, as seems likely, it was the upper levels of Roman society that suffered most from lead poisoning, some of these effects could have influenced the running of an empire. 

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