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Critical neurological conditions: severe toxic polyneuropathy with the development of respiratory failure and rhabdomyolysis
- Authors: Ryabinkina Y.V.1, Zakharova M.N.1, Polishchuk R.V.1, Luneva I.E.1, Pavlov E.V.1, Piradov M.A.1
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Affiliations:
- Research Center of Neurology
- Issue: Vol 12, No 3 (2018)
- Pages: 81-85
- Section: Clinical analysis
- Submitted: 11.10.2018
- Published: 11.10.2018
- URL: https://annaly-nevrologii.com/journal/pathID/article/view/541
- DOI: https://doi.org/10.25692/ACEN.2018.3.11
- ID: 541
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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
Россия, MoscowMaria N. Zakharova
Research Center of Neurology
Email: lunevairinaneurology@gmail.com
Россия, 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
Россия, 125367 Moscow, Volokolamskoye shosse, 80Irina E. Luneva
Research Center of Neurology
Author for correspondence.
Email: lunevairinaneurology@gmail.com
Россия, Moscow
Eduard V. Pavlov
Research Center of Neurology
Email: lunevairinaneurology@gmail.com
Россия, 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
Россия, MoscowReferences
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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).