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Acute methyl iodide exposure with delayed neuropsychiatric sequelae: report of a case
Michael D Schwartz1, Andrew O Obamwonyi, Jerry D Thomas
1Department of Emergency Medicine, Georgia Poison Center/Emory University, Atlanta, Georgia 30333, USA. aeo8@cdc.gov
Background:
Methyl iodide is a monohalomethane used as an analytic and organic chemistry reagent, as a methylating agent in organic chemical synthesis, and as a fumigant. In an acute exposure, methyl iodide is a pulmonary and dermal irritant. Chronic neurotoxicity has been reported in survivors of acute exposure.
Methods:
A review of the 11 case reports of methyl iodide poisoning in the medical literature of the 20th century found that six of the patients experienced a chronic neurological syndrome characterized primarily by delayed psychiatric, behavioral, and cognitive sequelae.
Results:
The case patient experienced a massive exposure to methyl iodide with resulting life-threatening burns. During convalescence, various cognitive and behavioral deficits became apparent. The results of a comprehensive evaluation at our occupational toxicology clinic, which included sequential neuropsychometric testing, are described.
Conclusion:
The findings in the case patient may advance our understanding of the mechanisms and clinical manifestations of chronic neurotoxicity after exposure to methyl iodide.
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