Reversible myoclonus, tremor, and ataxia in a patient exposed to methyl ethyl ketone

Unexpected sequelae of the COVID-19 pandemic: A strange case of myoclonus in the Tasmanian winter

Peritoneal dialysis treatment generates significant amounts of waste for disposal from patients' homes. In Australia, in the days after the onset of the COVID-19 pandemic, waste collection from homes was temporarily stopped. Our patient tried to dispose of his waste by burning the used bags and tubing, using paint thinner as an accelerant. We present a case report of the unusual neurological complication he developed.

Tremor secondary to neurotoxic exposure: mercury, lead, solvents, pesticides

Lead, mercury, solvents, and pesticide exposures are common in certain occupations and may cause nervous system dysfunction. Tremors may be the herald manifestation among a constellation of acute toxicity signs and symptoms. However, since tremors may also be the only sign on clinical presentation and since tremors also occur in other diseases, relating tremors to a specific occupational exposure can be challenging. Diagnosis of tremor etiology must be based on other findings on physical exam, laboratory results, and/or imaging. Discerning whether the tremor resulted from the occupational environment versus other etiologies requires knowledge of potential exposure sources, additional detail in history taking, and support of other health and industrial professionals. Reduction or removal from the exposure source remains the key first step in treating patients suffering from tremor that had resulted from occupational exposure toxicity.

Working conditions and related neuropsychiatric problems among shoemakers in Turkey: Do child workers differ from others?

Objective:

In this cross-sectional study, we investigated working conditions and related neuropsychiatric problems of shoemakers, including child workers, working in poor conditions with high health risks. Clinical diagnosis was not the objective of this study.

Materials and Methods:

We collected data from 318 workers ranging from 8-66 years of age. We evaluated working conditions, neuropathy symptoms and signs; urinary 2,5-hexanedione was used to estimate hexane exposure. We used the Zung depression scale for adult shoemakers to evaluate depression.

Results:

All workshops employed fewer than 10 workers with median daily work duration of 12h. Smoking and alcohol consumption were high among all workers including children. Peripheral neuropathy symptoms and signs were observed in 88 workers (27.8%) and it was related to alcohol consumption. Sixty-eight workers (47.9%) had depression and it was associated with daily work duration.

Conclusion:

Extremely poor, unhygienic, working conditions and a high prevalence of neuropsychiatric disorders were the main problems observed among shoemakers. A high number of child workers increased the scale of these observed problems.

Toxin-Induced Movement Disorders

Toxins can be cited as a cause of several movement disorders, but this association is rare and the resultant syndromes usually include additional signs that are not typical for the idiopathic movement disorders. Most instances of confirmed toxin-induced movement disorders show lesions on CT and MRI scans of cortical or subcortical structures. A common underlying element in these toxin-induced syndromes is the development of lesions primarily in the pallidum and striatum. Because many toxins result in lesions affecting these structures, a selective vulnerability to hypoxic or metabolic insults has long been postulated. The susceptibility of these structures may relate to a number of factors, including the pattern of oxidative metabolism, heavy metal concentration, vascular perfusion, and neuronal innervation. Finally, in addition to causing disability, certain neurotoxins have led to a better understanding of human disease through the development of research models. As an example, the MPTP model has not only provided an animal model to study therapeutic strategies in PD but has also contributed important insights into the mechanism of neuronal degeneration.