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[Voluntary barium poisoning]

J Fogliani1, E Giraud, D Henriquet

  • 1Service de Réanimation, Centre Hospitalier, Chambéry.

Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1993
PubMed
Summary

A man survived barium poisoning, which caused severe muscle weakness, respiratory failure, and kidney injury. Neurological damage led to Parkinsonian symptoms and swallowing difficulties, requiring prolonged mechanical ventilation.

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Area of Science:

  • Toxicology
  • Neurology
  • Nephrology

Background:

  • Barium poisoning is a rare but serious condition.
  • Ingestion of barium salts can lead to severe systemic toxicity.

Observation:

  • A 45-year-old man ingested a large amount of barium, resulting in hypokalemia, generalized muscle weakness, respiratory failure, and anuric renal insufficiency.
  • The patient required mechanical ventilation for three months and hemodialysis for three weeks due to barium toxicity.
  • Neurological sequelae included an extrapyramidal syndrome with tremor, myoclonus, hypertonia, parkinsonian rigidity, and esophageal sphincter contracture, leading to severe dysphagia.

Findings:

  • Magnetic Resonance Imaging (MRI) revealed bilateral hypersignals in the basal ganglia and thalamus.
  • The exact cause of the neurological syndrome (toxic vs. ischemic) remains undetermined.
  • Renal function recovered completely after hemodialysis, but neurological deficits persisted for an extended period.

Implications:

  • This case highlights the potential for severe, multi-systemic toxicity from barium ingestion.
  • The findings underscore the importance of early recognition and aggressive management of barium poisoning.
  • Further research is needed to elucidate the mechanisms of barium-induced neurotoxicity and long-term outcomes.

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