CHRONIC BROMVALERYLUREA INTOXICATION - DYSTONIC POSTURE AND CEREBELLAR-ATAXIA DUE TO NONSTEROIDAL ANTIINFLAMMATORY DRUG-ABUSE

Nalon-Ace(R) and other nonsteroidal anti-inflammatory drugs (NSAID) co ntaining bromvalerylurea (BW) are sold as over-the-counter (OTC) drugs and are obtainable without prescription in Japan. A 32-year-old woman was diagnosed as having chronic BW intoxication due to habitual use o f Nalon-Ace(R). In addition to cerebellar ataxia and pyramidal signs w ell known in this condition, she showed an as yet non-described dyston ic posture of the neck, Laboratory tests revealed an elevated concentr ation of serum organic bromide, iron deficiency anemia, and hyperchlor emia. Brain magnetic resonance imaging (MRI) revealed definite cerebel lar atrophy. We should consider the possibility of chronic BW intoxica tion in peculiar neurological cases like ours.