Reversible Neurotoxicity Due To Excessive Use of Ethyl Chloride.

Autor: Winkler GA; Division of Medical Toxicology, Department of Emergency Medicine, University of California at San Diego Medical Center, VA San Diego Healthcare System, San Diego, California., Dilbarova R; Department of Emergency Medicine, University of California at San Diego Medical Center, San Diego, California., Clark RF; Division of Medical Toxicology, Department of Emergency Medicine, University of California at San Diego Medical Center, San Diego, California., Schneir A; Division of Medical Toxicology, Department of Emergency Medicine, University of California at San Diego Medical Center, San Diego, California., Minns AB; Division of Medical Toxicology, Department of Emergency Medicine, University of California at San Diego Medical Center, San Diego, California.
Jazyk: angličtina
Zdroj: The Journal of emergency medicine [J Emerg Med] 2023 Feb; Vol. 64 (2), pp. 255-258. Date of Electronic Publication: 2023 Feb 17.
DOI: 10.1016/j.jemermed.2022.12.002
Abstrakt: Background: Ethyl chloride is commercially available as a DVD/VCR cleaner, and can be found as a gasoline additive and topical anesthetic. There is an emerging trend of recreational huffing to enhance sexual relations. Neurotoxicity from repeated abuse is uncommon.
Case Report: A 36-year-old man with a history of intermittent ethyl chloride use for 15 years presented to the Emergency Department with an inability to walk for 4 days after frequent use for 1 week. The patient reported a rapid titration of inhalation from zero to eight cans of 4.6 oz ethyl chloride aerosol per day over a 1-week period. Initial vital signs were heart rate 88 beats/min, blood pressure 147/60 mm Hg, temperature 37.2°C (99°F), and respiratory rate 16 breaths/min. Physical examination was notable for slurred speech, ptosis, a wide-based and ataxic gait with short strides, inability to stand without support, loss of toe/finger proprioception, horizontal and vertical nystagmus, and dysmetria on coordination testing. Strength and sensation were preserved. His work-up included computed tomography and magnetic resonance imaging of the brain, cervical, thoracic, and lumbar spine that demonstrated no acute abnormalities. On hospital day 9, the patient was able to ambulate with mild difficulty. WHY SHOULD AN EMERGENY PHYSICIAN BE AWARE OF THIS?: Toxicity from excessive ethyl chloride huffing has been rarely reported. The toxicity was characterized with cerebellar findings, no attributable laboratory abnormalities, and no radiographic abnormalities on computed tomography/magnetic resonance imaging. The neurotoxicity resolved with supportive care. This case of excessive huffing of ethyl chloride presenting with neurotoxicity and ataxia further characterizes a rare complication of ethyl chloride toxicity that is gaining popularity.
(Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: