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[双硫仑神经病变。3例报告]

[Disulfiram neuropathy. Report of 3 cases].

作者信息

Bevilacqua Jorge A, Díaz Mario, Díaz Violeta, Silva Carlos, Fruns Manuel

机构信息

Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, José Joaquín Aguirre, Programa de Morfología, ICBM, Facultad de Medicina, Universidad de Chile.

出版信息

Rev Med Chil. 2002 Sep;130(9):1037-42.

Abstract

Disulfiram is widely used for aversive treatment of alcoholism. Although it is well tolerated in most patients, one in 15,000 patients will develop peripheral neuropathy every year, which is frequently misdiagnosed as alcoholic neuropathy. Disulfiram neuropathy can be mild or severe, depending on diverse factors such as time of exposure and the dosage. Most patients will present with a motor-sensory neuropathy of the lower limbs, which tends to improve as disulfiram administration ceases, however some cases may remain with permanent sequelae. We report the clinical, laboratory and electrophysiological features of three patients who developed disulfiram neuropathy during treatment of alcoholism. Recovery was incomplete at 8 weeks after treatment cessation in all of them. No other findings justified the clinical features described in these patients. Considering the incidence of alcoholism and the wide use of disulfiram treatment in Chile, we suggest that disulfiram neuropathy is being underdiagnosed. We also stress the fact that disulfiram neuropathy could be avoided by using lower doses.

摘要

双硫仑广泛用于酒精中毒的厌恶疗法。尽管大多数患者对其耐受性良好,但每年每15000名患者中就有1人会发生周围神经病变,这种病变常被误诊为酒精性神经病变。双硫仑神经病变可轻可重,这取决于接触时间和剂量等多种因素。大多数患者会出现下肢运动感觉神经病变,随着双硫仑停用,病情往往会有所改善,然而有些病例可能会留下永久性后遗症。我们报告了3例在酒精中毒治疗期间发生双硫仑神经病变患者的临床、实验室和电生理特征。在停止治疗8周后,他们的恢复均不完全。没有其他发现能够解释这些患者所描述的临床特征。考虑到智利酒精中毒的发病率以及双硫仑治疗的广泛应用,我们认为双硫仑神经病变可能未得到充分诊断。我们还强调,使用较低剂量可避免双硫仑神经病变。

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