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KMID : 0374920170380010091
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Inje Medical Journal
2017 Volume.38 No. 1 p.91 ~ p.97
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A Case of Persistent Axial Ataxia Precipitated by Dichloromethane Intoxication
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Lee Jae-Jung
Song Pamela
Cho Joong-Yang
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Abstract
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A dichloromethane is a well-known organic solvent, in which an over-exposure is likely to result in a wide variety of toxic manifestations including dizziness, headaches, nausea, altered consciousness, and even fatalities. There have been several reports of dichloromethane intoxication but little is known about the cerebellar dysfunction or retained disability. Herein, we report the case of dichloromethane intoxication presenting with long lasting overt axial ataxia. A 56-year-old man, who worked in a car air filter factory, presented with occurrence of 4 days history of dizziness, headache, and listlessness with unsteady posture. He had done the work for cleaning up the polyurethane by means of dichloromethane solution in relatively enclosed circumstances. He showed cerebellar type dysarthria, prominent truncal tilting and ataxia even being unable to hold steady sitting position. However, an overt ataxia was neither observed on limb nor eye movement. Initial brain CT and MRI revealed unremarkable appearances. A laboratory tests were unremarkable as well including carboxy hemoglobin. Despite conservative and symptomatic management, the troublesome dizziness and headaches were modestly relieved and an axial ataxia with gait disturbance did not show any improvement. Intoxication by dichloromethane is likely to result in a persistent cerebellar dysfunction in axial part of body in particular. Whether the disabilities are reversible is obscure. Use of desirable protective equipment and to avoid enclosed spot while dealing with dichloromethane is crucial to prevent fatal intoxications.
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KEYWORD
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Dichloromethane, Cerebellar ataxia
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