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Acute encephalopathy and polyneuropathy after disulfiram intoxication
1Department of Neurology, University of Trieste, Cattinara Hospital, Italy.
Alcohol and Alcoholism (Oxford, Oxfordshire)
|September 1, 1995
Summary
High doses of disulfiram, even without alcohol, can cause severe neurological damage. This case highlights disulfiram (DSF) toxicity leading to acute encephalopathy and persistent tetraparesis.
Area of Science:
- Neuroscience
- Toxicology
- Pharmacology
Background:
- Disulfiram (DSF) is a medication used to deter alcohol consumption.
- It functions by inhibiting aldehyde dehydrogenase, leading to acetaldehyde accumulation upon alcohol intake.
- High-dose disulfiram toxicity is rare, especially without concurrent alcohol use.
Observation:
- A chronic alcoholic ingested a very high dose of disulfiram (29 g over 1 week) without alcohol.
- The patient developed acute encephalopathy and severe flaccid tetraparesis.
- Neurological symptoms worsened over several days, persisting even after drug cessation.
Findings:
- Disulfiram overdose can induce severe neurotoxicity, including encephalopathy and tetraparesis.
- Symptoms may manifest and progress independent of alcohol consumption.
- Neurological deficits can be prolonged, with slow and incomplete recovery.
Implications:
- This case underscores the potential for severe neurological adverse effects from disulfiram overdose.
- It highlights the importance of careful dosing and monitoring, even in patients not actively consuming alcohol.
- Clinicians should be aware of disulfiram's neurotoxic potential beyond the typical disulfiram-alcohol reaction.