Branch R A, Jacqz E
Am J Med. 1986 Apr;80(4):741-5. doi: 10.1016/0002-9343(86)90837-5.
Carbaryl, a widely used insecticide, is reputed to have a wide safety margin. It can induce acute cholinesterase poisoning, which is rapidly reversible on discontinuation of exposure. Long-term sequelae from long-term exposure have not previously been described in humans. This report describes the experience of a 75-year-old man who had long-term excessive exposure to carbaryl and in whom a debilitating syndrome, including headaches, memory loss, proximal muscle weakness, muscle fasciculation, muscle cramps, and anorexia with marked weight loss, developed. At the time of diagnosis, serum pseudocholinesterase levels were low, and his major symptoms resolved on termination of exposure. Late clinical features were sleep apnea and progressive development of a peripheral neuropathy. The difficulty in diagnosing the cause of a group of relatively nonspecific symptoms raises the question of whether chronic carbaryl neurotoxicity might be occurring more frequently than previously suspected.
西维因是一种广泛使用的杀虫剂，据称具有很大的安全范围。它可引发急性胆碱酯酶中毒，停止接触后中毒症状可迅速逆转。此前，人类长期接触西维因的长期后遗症尚未有过描述。本报告描述了一名75岁男性的经历，该男子长期过度接触西维因，随后出现了一种使人衰弱的综合征，包括头痛、记忆力减退、近端肌无力、肌肉束颤、肌肉痉挛以及伴有明显体重减轻的厌食症。在诊断时，血清假性胆碱酯酶水平较低，停止接触后其主要症状得到缓解。晚期临床特征为睡眠呼吸暂停和周围神经病变的进行性发展。对于一组相对非特异性症状的病因诊断困难，这引发了一个问题，即慢性西维因神经毒性的发生频率是否可能比之前怀疑的更高。
