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

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Abstract

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

Email: lunevairinaneurology@gmail.com
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

Email: lunevairinaneurology@gmail.com
Russian Federation, Moscow

Roman V. Polishchuk

Research Center of Neurology

Email: lunevairinaneurology@gmail.com
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.
Email: lunevairinaneurology@gmail.com
Russian Federation, Moscow

Eduard V. Pavlov

Research Center of Neurology

Email: lunevairinaneurology@gmail.com
Russian Federation, Moscow

Mikhail A. Piradov

Research Center of Neurology

Email: lunevairinaneurology@gmail.com
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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