Neurologic Disturbances

About 30 per cent of patients with ACD complain of symptoms referable to the nervous system. The neurologic symptomatology may be quite complex, and it is not possible in each case to decide whether symptoms result from cerebrovascular involvement or from lipid storage in nerve cells. Acute hemiparesthesia, hemi-paresis or hemiplegia in some cases is suggestive of a vascular cause, and may be fatal (Duperrat and Pluvinage 1956, Bass 1958). 

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The identification of co-occurring medical problems is an important element in detoxification (Naranjo and Sellers 1986). Good supportive care and treatment of concurrent illness, including fluid and electrolyte repletion, are essential (Naranjo and Sellers 1986). Administration of thiamine (50—100 mg/day po or im) and multivitamins is a low-cost, low-risk intervention for the prophylaxis and treatment of alcohol-related neurological disturbances. 

Sodium valproate Inhibits GABA 600-1200 mg/day Neurologic disturbances, Variable efficacy seen in Cushing s... 

Dollahite JW, Pierce KR. 1969. Neurologic disturbances due to triaryl phosphate toxicity. Am J Vet Res 30 1461-1464. 

Acute-Duration Exposure. Information is available regarding the effects of acute-duration inhalation exposure of humans to acrylonitrile and the effects are characteristic of cyanide-type toxicity. Quantitative data are limited but are sufficient to derive an acute inhalation MRL. Further studies of humans exposed to low levels of acrylonitrile in the workplace would increase the confidence of the acute MRL. Studies in animals support and confirm these findings. No studies are available on the effects of acute-duration oral exposure in humans however, exposure to acrylonitrile reveals neurological disturbances characteristic of cyanide-type toxicity and lethal effects in rats and mice. Rats also develop birth defects. Animal data are sufficient to derive an acute oral MRL. Additional studies employing other species and various dose levels would be useful in confirming target tissues and determining thresholds for these effects. In humans, acrylonitrile causes irritation of the skin and eyes. No data are available on acute dermal exposures in animals. 

Prenatal and postnatal diagnoses can be made by enzyme assay of cultured amniocytes, fibroblasts or white blood cells. Treatment remains symptomatic. Sodium bicarbonate is necessary to correct the acidosis. Aspartic acid supplementation will improve the systemic condition but has no effect on the neurological disturbances. Biotin supplementation is of no value. 

There are a large number of hereditary or acquired disturbances of porphyrin synthesis, known as porphyrias, some of which can cause severe clinical pictures. Several of these diseases lead to the excretion of heme precursors in feces or urine, giving them a dark red color. Accumulation of porphyrins in the skin can also occur, and exposure to light then causes disfiguring, poorly healing blisters. Neurological disturbances are also common in the porphyrias. 

The function of glutamate as a stimulatory transmitter in the brain is the cause of what is known as the Chinese restaurant syndrome. In sensitive individuals, the monosodium glutamate used as a flavor enhancer in Chinese cooking can raise the glutamate level in the brain to such an extent that transient mild neurological disturbances can occur (dizziness, etc.). 

In chronic alcoholics, thiamine deficiency may manifest as Wernicke-Korsakoff syndrome, which Is characterized by a constellation of unusual neurologic disturbances. Including amnesia, apathy, and nystagmus. 

Closely monitor for signs and symptoms of GI or neurologic disturbances, particularly paresthesias... 

Adverse effects include nausea, vomiting, rash. Bone marrow depression is the major toxic effect. Alopecia, stomatitis, dysuria inflammation and increased pigmentation may occur in areas exposed to radiation. Rarely neurological disturbances occur. 

It is indicated to prevent and treat isoniazid, hydralazine, penicillamine and cycloserine induced neurological disturbances, mental symptoms in women on oral contraceptives, pyridoxine responsive anaemia and homocystinuria, morning sickness and hyperemesis gravidarum, convulsions in infants and children. 

Chronic oral therapy with amiodarone is associated with several side effects, including pulmonary toxicity (fibrosis and probably immunologically mediated pneumonitis), hepatotoxicity, thyroid gland dysfunction, corneal microdeposits, blue-grey skin discoloration and neurological disturbances. 

Other neurologic disturbances associated with alcoholism include dementia and, rarely, demyelinating disease. 

The adverse effects of ritonavir comprise GI discomfort including abdominal pain, nausea, diarrhea, vomiting, asthenia and neurological disturbances. Taste perversion, peripheral paresthesias and lipodystrophy including elevated levels of triglycerides and cholesterol have also been reported with its administration. 

Ethanol, C2H5OH, is the component in alcoholic beverages that produces the neurological disturbances associated with... 

Chlordane Generalized convulsions, reproductive toxicity, birth defects, loss of consciousness, change in EEG pattern, hepatic disorders, neurologic disturbances, mutagenicity, carcinogenicity... 

The use of DA-ergic forms of medication in other forms of neurological disturbance is not well developed, but case study reports and experimental findings suggest possible... 

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