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[Acute suicidal carbofuran poisoning--case report]
Tomasz Gawlikowski1, Alicja Hubalewska-Dydejczyk, Dorota Pach
1Oddzial (Kliniczny) Toksykologii i Chorób Srodowiskowych WSS im. L. Rydygiera w Krakowie. togawlik@mp.pl
Przeglad Lekarski
|August 30, 2007
Summary
This case study details a severe carbofuran poisoning in a 49-year-old woman, revealing significant disturbances in regional cerebral blood flow and neuropsychological deficits despite normal brain imaging.
Area of Science:
- Neuroscience
- Toxicology
- Radiology
Background:
- Carbamate pesticides, like carbofuran, are known neurotoxins that inhibit acetylcholinesterase (AChE), leading to potential multiorgan damage.
- Acute, severe poisoning necessitates comprehensive neurological assessment to understand the extent of central nervous system involvement.
Observation:
- A 49-year-old female presented with acute, severe suicidal carbofuran poisoning, exhibiting the lowest recorded AChE activity at 0 IU/L.
- Initial brain computed tomography (CT) scans showed no pathological changes.
- Regional cerebral blood flow (99mTc-ECD SPECT) and neuropsychological examinations were performed during hospitalization.
Findings:
- 99mTc-ECD SPECT imaging, conducted on day 14, indicated disturbed regional cerebral blood flow, predominantly in the frontal and occipital lobes.
- Neuropsychological testing results were also pathological, correlating with the cerebral blood flow findings.
Implications:
- This case highlights the potential for delayed or subtle central nervous system damage in severe carbofuran poisoning, even when initial CT scans are normal.
- Cerebral blood flow imaging and neuropsychological assessments are crucial for evaluating the neurological sequelae of carbamate toxicity.
- Findings suggest that monitoring and rehabilitation strategies should address potential cognitive and functional impairments following severe carbofuran exposure.
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