Headache case study

In the past, trichloroethylene was used as a human anesthetic. Trichloroethylene has also been used by individuals who intentionally inhale it for its narcotic properties. Therefore, most of the information regarding the effects of trichloroethylene in humans comes from case studies and experiments describing effects of trichloroethylene after inhalation exposure. These studies indicate that the primary effect of exposure to trichloroethylene is on the central nervous system. Effects include headache, vertigo, fatigue, short-term memory loss, decreased word associations, central nervous system depression, and anesthesia. 

Only one report of human death attributed to 1,4-dichlorobenzene exposure has been located in the literature. A 60-year-old man and his wife died within months of each other due to acute yellow atrophy of the liver (also known as massive hepatic necrosis or fulminant hepatitis) (Cotter 1953). Their home had been "saturated" with 1,4-dichlorobenzene mothball vapor for a period of about 3-4 months, but no air measurements were available. Clinical symptoms included severe headache, diarrhea, numbness, clumsiness, slurred speech, weight loss (50 pounds in 3 months in the case of the husband), and jaundice. The wife died within a year of the initial exposure however, it was not clear if 1,4-dichlorobenzene was the primary cause of death. This case study did not address whether these individuals consumed excessive amounts of alcohol or had previous medical problems, such as a chronic liver infection. 

Abdominal cramps, vomiting, and diarrhea occurred in a truck driver who was exposed to diesel fuel vapor for 10 days while driving a truck with a leaking fuel injector. Acute renal failure was also observed. One case study describes eye irritation in two individuals exposed to JP-5 fuel (kerosene) for approximately 1 hour while flying an airplane. Coordination and concentration difficulties were noted, as were headache, apparent intoxication, and anorexia. Inhalation of 140mg/m deodorized kerosene by six volunteers caused olfactory fatigue in three subjects and a taste sensation in... 

Case studies have associated exposure to mercury vapor with neurological effects (e.g., tremors, insomnia, shyness, emotional instability, decreased motor function and muscle reflexes, headaches, and abnormal EEGs) (Davis et al. 1974 Jaffe et al. 1983 McFarland and Reigel 1978). Some studies have examined the relationship between nerve function and mercury levels in blood, urine, and tissue. Tissue levels of mercury have also been found to correlate with impaired nerve function. Among 23 dentists with mercury levels greater than 20 g/g (measured in wrist tissue), 30% exhibited reduced nerve conduction velocity when compared with dentists with tissue levels of mercury below 20 g/g (Shapiro et al. 1982). The decrease in nerve conduction velocity was observed in both sensory and motor nerves. 

Scopp AL. MSG and hydrolyzed vegetable protein induced headache Review and case studies. Headache 1991 31(2) 107-10. 

SAD can present in children of preschool to elementary school age. If the disorder is not treated, it can persist into adulthood and increase the risk of depression and substance abuse. CBT and social skills training are effective nonpharmacological therapies in children. Pharmacological evidence is limited to case studies or open-label trials. SSRIs are considered first-line therapy because of tolerability and effectiveness. Fluoxetine, fluvoxamine, sertraline, and paroxetine were effective in children with SAD. Headache, nausea, drowsiness, insomnia, jitteriness, and stomach aches were reported in children receiving SSRIs. 

Neurological effects following nitrobenzene ingestion by humans have been reported as headache, nausea, vertigo, confusion, unconsciousness, apnea and coma (Carter 1936 Leader 1932 Myslak et al. 1971). Levels of nitrobenzene associated with these effects cannot be reliably estimated in most of the case studies from which these descriptions have been derived. 

Neurotoxicity. Neurological effects including headache, nausea, vertigo, and confusion have been reported in case studies of humans exposed to nitrobenzene by inhalation. In orally exposed persons, apnea and coma have additionally been reported. No data are available in humans exposed via the dermal route. In animal studies, brain lesions have been observed in mice and rats exposed by inhalation and in rats that received a single oral dose. No data are available in animals exposed via the dermal route. Toxicokinetic studies in mice and rats provide evidence that nitrobenzene is distributed to brain tissue. Both the human and animal data provide clear evidence that nitrobenzene is a neurotoxic substance. Further studies in this area do not appear to be needed. In addition, results of the CUT two-year bioassay may provide further information on this end point. 

Convulsions and unconsciousness, accompanied by headache, dizziness, and vomiting, were noted in 5 out of 26 workers who were exposed to unknown levels of RDX dust in the air (Kaplan et al. 1965). Similar findings, such as convulsions, muscle twitching, and confusion, have been reported in five case studies of men exposed to C-4 fumes (91 % RDX) when it was used as a cooking fuel... 

Toxicology. The acute oral and dermal toxicity of naphthalene is low with LD q values for rats from 1780—2500 mg/kg orally (41) and greater than 2000 mg/kg dermally. The inhalation of naphthalene vapors may cause headache, nausea, confusion, and profuse perspiration, and if exposure is severe, vomiting, optic neuritis, and hematuria may occur (28). Chronic exposure studies conducted by the NTP ia mice for two years showed that naphthalene caused irritation to the nasal passages, but no other overt toxicity was noted. Rabbits that received 1—2 g/d of naphthalene either orally or hypodermically developed changes ia the lens of the eye after a few days, foUowed by definite opacity of the lens after several days (41). Rare cases of such corneal epithelium damage ia humans have been reported (28). Naphthalene can be irritating to the skin, and hypersensitivity does occur. 

The metal itself, having an appreciable vapour pressure, is also toxic, and produces headaches, tremors, inflammation of the bladder and loss of memory. The best documented case is that of Alfred Stock (p. 151) whose constant use of mercury in the vacuum lines employed in his studies of boron and silicon hydrides, caused him to suffer for many years. The cause was eventually recognized and it is largely due to Stock s publication in 1926 of details of his experiences that the need for care and adequate ventilation is now fully appreciated. 

CDC Case Definition An illness characterized by acute or insidious onset of fever, night sweats, undue fatigue, anorexia, weight loss, headache, and arthralgia. Laboratory criteria for diagnosis is (1) isolation of Brucella species from a clinical specimen or (2) fourfold or greater rise in Brucella agglutination titer between acute- and convalescent-phase serum specimens obtained >2 weeks apart and studied at the same laboratory or (3) demonstration by immunofluorescence of Brucella species in a clinical specimen. 

There is probably a wide variation in the susceptibility of individuals in the population to the induction of headache from various stimuli. However, in the case of individuals exposed to PGDN in the study by Stewart et al. 

Leopold and Comroe2 studied the use of 0 05, 01 and 0-2 per cent D.F.P. in arachis oil in glaucoma, and found that cases unrelieved by eserine responded readily to 01 per cent D.F.P. instilled into the conjunctival sac. However, the action of D.F.P. in the glaucomatous eye lasts for about 12 hr. compared to an action of about 12 days in the normal eye. The short-lived action of D.F.P. in cases of raised intra-ocular tension lends evidence to the suggestion that there may be an upset of the acetylcholine-cholinesterase mechanism in glaucoma. There are certain side effects such as ciliary spasm and headache which may prove troublesome during treatment. 

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