M. Lifshitz et V. Gavrilov, Central nervous system toxicity and early peripheral neuropathy following dermal exposure to methyl bromide, J TOX-CLIN, 38(7), 2000, pp. 799-801
Case Report: We describe a case of early peripheral neuropathy and central
nervous system toxicity as a result of acute predominantly dermal exposure
to methyl bromide. A 32-year-old male was admitted after an accidental pred
ominantly dermal exposure to methyl bromide while fumigating soil for pest
control. The patient suffered dermal burns and vesicles on the upper and lo
wer limbs. One week following exposure, he developed progressive weakness o
f the lower limbs, ataxia, paresthesiae of both legs and the left arm, hype
ractive tendon reflexes in the lower limbs, and left Babinski sign. Nerve c
onduction velocity testing was compatible with axonal neuropathy. The patie
nt recovered gradually from his burns. Three months postexposure he showed
no signs of central nervous system toxicity, but the peripheral neuropathy
was still present. Discussion: Neurological effects primarily referable to
the central nervous system following severe inhalation of methyl bromide ha
ve frequently been reported. The patient described in this study, developed
an unusual early peripheral neuropathy following dermal exposure. Peripher
al neuropathy can be an outcome of methyl bromide intoxication, but is usua
lly a late sequela of acute central nervous system toxicity or an aftereffe
ct of repetitively inhaled chronic exposure. In this case, exposure to meth
yl bromide through abraded skin caused early peripheral neuropathy and cent
ral nervous system toxicity.