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Diagnostic Application of Energy Dispersive Spectroscopy to Chronic Bromvalerylurea Intoxication Yasuo Kurokawa 1 , Ryo Fukatsu 1 , Yoichiro Takasaka 1 , Tatsuo Chiba 1 , Yutaka Asano 2 1Department of Psychiatry and Neurology, School of Medicine, Hokkaido University 2Department of Psychiatry, Muroran City General Hospital Keyword: Bromide intoxication , Serum bromide level , X-ray microanalysis , Energy dispersive spectroscopy , Analytical electron microscopy pp.315-321
Published Date 1986/3/15
DOI https://doi.org/10.11477/mf.1405204121
  • Abstract
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 Bromvalerylurea has long been used as a hypnotic, and is known to cause complicated neurological symptoms and signs as well as psychiatric ones such as delirium, hallucination, etc. Because patients often hesitate to admit the use of bromvalerylurea, it is usually difficult to reach correct diagnosis of the intoxication. In this study, three cases of chronic bromvalerylurea intoxication were described. All the cases showed nystagmus, gait disturbance and hyperreflexia of the limbs. Dysarthria, double vision, hypotonia and ataxic gait were also observed frequently. As a very rare sign, auditory agnosia was found in one case. Differential diagnosis was necessary to rule out hysterical state, multiple sclerosis, hypoglycemia, porphylia, myasthenia gravis and epilepsy.

 In order to detect bromin, energy dispersive spectroscopy (EDX) was used for analysing serum, urine and cerebrospinal fluid of the three cases. Five micro liter of the specimen was placed on the carboncoated mesh and dehydrated, then using TN-2000 analyzer, characteristic X-ray peaks were examined. Distinct peaks for bromin were obtained from the serum and urine, but peaks from the cerebrospinal fluid were very small. For the purpose of determining the sensitivity of this method, potassium bromide diluted with normal human serum was tested. The study showed that the sensitivity to detect bromin in serum is 30 micro gram per ml. This method is sensitive enough for the diagnosis of bromide intoxication.


Copyright © 1986, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-126X 印刷版ISSN 0488-1281 医学書院

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