Encephalopathic Changes

Although subtle behavioral changes are noted in animals soon after cduminum infusion, with increasing time the behavioral changes become more severe as overt neuropathological signs ap- 

As pointed out earlier, some species such as the rat, fail to develop an encephalopathy. Even when observed for 12 months after injection of massive amounts of aluminum, no motor signs of an encaphalopathy appear.  

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Adverse Reactions Inflammation or phlebitis at injection site Transient elevations in serum creatinine and BUN Nausea and/or vomiting Itching, rash, or hives Elevation of transaminases Encephalopathic changes, including lethargy, obtundation, tremors, confusion, hallucinations, agitation, seizures, and coma... 

Lead levels at which encephalopathic changes occur in man... 

In recent years, interest in the clinical problems related to low-level lead exposure has directed experimental attention away from high-dose systems with vascular encephalopathic changes to others where lower doses of lead are given in an attempt to identify less dramatic neurotoxic effects. Table 4 lists a number of experimental systems abstracted from the literature of the past 16 years. In these, rats have been subjected to lead exposure via every conceivable route of administration, and a bewildering number of doses. 

An 8-year-old boy with complex partial seizures had taken valproate for more than 3 years. His sister developed uncomplicated hepatitis A, and 1 month later he became jaundiced, developed fulminant hepatic failure, quickly became encephalopathic, and died, despite withdrawal of valproate, aggressive supportive therapy, and treatment with carnitine. He had positive hepatitis A IgM other causes for acute hepatitis were ruled out. Liver pathology showed distended hepatocytes with cholestasis and microvesicular changes. 

Examination of cell number by DNA analysis shows no change for the whole brain after 30 d high Pb exposureAt 60 d of age, however, there was an increase in whole brain DNA, which the authors interpreted as diffuse gliosis in Pb-intoxicated animals. Lead does produce a 10-20% reduction in the DNA of the cerebellum in 3-week-old rat pups exposed to encephalopathic levels of Pb. This suggests that postnataUy dividing cells of the cerebellum are sensitive to the effects of Pb, and that there may be an ultimate reduction in the number of cells in this brain area. Such a reduction in cerebellar DNA is not found sifter low doses of Pb. ... 

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