Critical neurological conditions: severe toxic polyneuropathy with the development of respiratory failure and rhabdomyolysis

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This is a description of the clinical case of severe toxic polyneuropathy in a 52-year-old man, caused by a confirmed exogenous intoxication with amphetamine.

The clinical picture was remarkable for muscle weakness in different muscle groups: neck, back, arms and legs, respiratory muscles; as well as for the respiratory failure (requiring mechanical ventilation), rhabdomyolysis, mild nephropathy, liver cytolysis. A differential diagnosis was made between myasthenia gravis, myopathy, amyotrophic lateral sclerosis. After a course of intensive therapy, almost complete regression of symptoms took place, as well as the improvement of electroneuromyographic pattern. Taking into account a rapid partial regression of symptoms in the course of the disease, as well as the results of a neurophysiological study, an immunochromatographic urine drug screen was performed, positive for amphetamine. This clinical case demonstrates "rare" complications of amphetamine use to be kept in mind during a diagnostic search.

About the authors

Yulia V. Ryabinkina

Research Center of Neurology

ORCID iD: 0000-0001-8576-9983

D. Sci. (Med.), Head, Department of anesthesiology and intensive care

Russian Federation, Moscow

Maria N. Zakharova

Research Center of Neurology

Russian Federation, Moscow

Roman V. Polishchuk

Research Center of Neurology

ORCID iD: 0000-0003-2850-3999

anesthesiologist-reanimatologist, neurologist, Intensive critical care department

Russian Federation, 125367 Moscow, Volokolamskoye shosse, 80

Irina E. Luneva

Research Center of Neurology

Author for correspondence.
Russian Federation, Moscow

Eduard V. Pavlov

Research Center of Neurology

Russian Federation, Moscow

Mikhail A. Piradov

Research Center of Neurology

ORCID iD: 0000-0002-6338-0392

D. Sci. (Med.), Professor, Full Member of the Russian Academy of Sciences, Director

Russian Federation, Moscow


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Copyright (c) 2018 Ryabinkina Y.V., Zakharova M.N., Polishchuk R.V., Luneva I.E., Pavlov E.V., Piradov M.A.

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