Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

Diffuse cerebral atrophy and reversible polyneuropathy in a patient with chronic Bromvalerylurea intoxication: a case report

Yoichi Kanatsuka, M.D.1), Makiko Inaoka, M.D.2), Kensuke Nakazawa, M.D.3), Shiori Asano, M.D.3), Izumi Mori, M.D., Ph.D.4) and Shigeki Yamaguchi, M.D., Ph.D.1)

1) Department of Neurology, Yokohama Municipal Citizen's Hospital
2) Department of Psychiatry, Sakuragaoka Kinen Hospital
3) Department of Neurology, Yokohama Minami Kyousai Hospital
4) Department of Neurology, Shonan Hospital

A 37-year-old man who had been on bromvalerylurea (BU) medication for 11 years at a maximum dose of 2,400 mg per day for headache therapy was admitted to our hospital due to gait disturbance. He had weight loss and exanthema all over his body. Cognitive dysfunction, intellectual deterioration, attention disturbance, decreased muscle strength, and decreased vibratory sense in the lower limbs were observed. Brain MRI showed diffuse brain atrophy, and a peripheral nerve conduction examination revealed decreased nerve conduction velocity and action potential amplitude in the extremities. We diagnosed him with chronic BU intoxication based on pseudohyperchloremia, BU detected in the blood, and bromide elevation. By discontinuing BU and performing intravenous infusion, neurological symptoms and exanthema were improved, and peripheral nerve conduction examination findings also improved. There are few reports of peripheral neuropathy cases of chronic BU intoxication; herein we report one such case along with previously reported cases.
Full Text of this Article in Japanese PDF (1847K)

(CLINICA NEUROL, 60: 795|798, 2020)
key words: bromvalerylurea, brain atrophy, neuropathy, intoxication, reversible

(Received: 28-Apr-20)