The enigma of parkinsonism in chronic borderline mercury intoxication, resolved by challenge with penicillamine.
International Neurotoxicology Conference. Hot Springs, Arkansas USA, 1994/10/30.
The Enigma of Parkinsonism in Chronic Borderline Mercury Intoxication, Resolved by Challenge with Penicillamine.
Neurotoxicology 17 (1) : 291296,1996.
A 47 year old female dentist suffered from hemiparkinsonism which had started eighteen months earlier and was manifested mainly by resting tremor and cogwheel rigidity.
A baseline quantitative urinary mercury excretion was 46 mug/day.
The patient was treated with chelating agent d-penicillamine for a week.
Chelation therapy resulted in clinical improvement of parkinsonism and in dynamic changes in daily urinary mercury excretion with a prompt increase to 79 mug/day, a subsequent decline followed by increase in the mercury urinary excretion.
After a week chelation therapy was stopped.
During a follow-up period of five years, the neurological status remained unchanged after the initial penicillamine-induced improvement.
This case may be evidence, therefore, of a rare clinical variant of elemental mercury intoxication associated with parkinsonism, in the absence of most classical neuropsychiatric signs of chronic mercurialism.
Mots-clés Pascal : Mercure, Métal lourd, Exposition professionnelle, Dentiste, Médecine travail, Parkinson maladie, Homme, Toxicité, Traitement, Chimiothérapie, Chélateur, Antidote, Pénicillamine, Etude cas, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie, Extrapyramidal syndrome, Maladie dégénérative
Mots-clés Pascal anglais : Mercury, Heavy metal, Occupational exposure, Dentist, Occupational medicine, Parkinson disease, Human, Toxicity, Treatment, Chemotherapy, Chelating agent, Antidote, Case study, Nervous system diseases, Central nervous system disease, Cerebral disorder, Extrapyramidal syndrome, Degenerative disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0357561
Code Inist : 002B03L05. Création : 10/04/1997.