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Brain and Nerve No to Shinkei Volume 26, Issue 10 （October 1974）

Brain and Nerve 脳と神経 26巻10号（1974年10月発行）

Japanese English

原著

主として知覚系の障害を呈したメチルブロマイド中毒の1症例について METHYLBROMIDE POISONING:A CASE OF NEUROLOGICAL DISTURBANCES RELATIVELY RESTRICTED TO THE SENSORY SYSTEM 山内俊雄 ¹ , 諸治隆嗣 ² , 高橋三郎 ³ Toshio Yamauchi ¹ , Takashi Moroji ² , Saburo Takahashi ³ ¹北海道大学医学部精神医学教室 ²現在：東京都精紳医学総合研究所精神薬理研究部門 ³現在：岩見沢市立総合病院精神神経科 ¹Department of Psychiatry and Neurology, Hokkaido University, School of Medicine ²Division of Psychopharmacology, Psychiatric Research Institute of Tokyo ³Section of Neuropsychiatry, Iwamizawa municipal General Hospital pp.1005-1011

発行日 1974年10月1日 Published Date 1974/10/1

DOI https://doi.org/10.11477/mf.1406203610

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Abstract 文献概要
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　メチルブロマイド（Methylbromide, CH₃Br，臭化メチル）は，燻蒸剤，消火剤，冷却剤や工業用メチル化物質などに広く用いられるが，この物質は容易にガス状となり，呼吸器系，皮膚，粘膜などを通して体内に吸収され，種々の中毒症状を呈することが知られている。

　メチルブロマイドによる中毒の最初の症例は1889年にSchuler^15）によつて報告されたが，その後，現在までに発表された症例をみると，その中毒症状は，呼吸器系の障害，神経症状，精神症状，腎症状，皮膚症状などと多岐にわたつている。

A case of methylbromide poisoning which was relatively restricted to the sensory system is pre-sented.

A 25 year old man had been working as a fumigator for five years.

On the day of his illness (April 7, '73), one hour and thirty minutes after fumigation, he experienced a sudden onset of vertigo and loss of consciousness (suspected).

Five days later, he had a numbness on the both soles, and within two or three days it gradually developed into hypesthesia, paresthesia and hyperal-gesia, and spread to the lumbar level.

When he came to our hospital on March 25, '73, the neurological examination revealed the follow-ings.

The pupils were slightly dilated and unequal (R: 7mm, L: 6.5mm), and reaction to light was sluggish. There were no other abnormal cranial nerve findings. Both Achilles tendon reflexes were absent. No pathological reflexes were elicited. There were neither motor weakness nor muscle atrophy. Sensory examination revealed hypesthesia, paresthesia and hyperalgesia over limbs and the lumbar region. These sensory disturbances were more marked over the distal portion.

After admission to our hospital on May 2, '73, he was treated with ATP, Vitamine B6, B6, B12 and Nicotinic acid.

Sensory symptoms were improved gradually and the upper level of hypesthesia was decreased to the lower half of the legs on March 20. But six months after the onset of his illness, Achilles tendon reflexes were still absent or very difficult to elicit, and paresthesia over the soles were per-sisted.

The laboratory studies showed that serum and CSF Cl value were increased slightly at the early stage. EEG showed slow wave burst temporarily, and revealed the low threshold for Bemegride activation.

The M wave evoked by motor nerve stimulation was observed in latency of about 5.5 msec, but H wave evoked reflectively by sensory nerve stimu-lation was hardly obtained.

These findings suggest that the sensory system is involved chiefly.

The symptom of Methylbromide poisoning had been briefly discussed.