Fukazawa T, Sasaki H, Ito-Owada Y, Hamada T, Tashiro K
Hokuyukai Neurology Hospital, Sapporo, Japan.
Rinsho Shinkeigaku. 1996 Jun;36(6):790-2.
A 28-year-old man presented with a bilateral visual loss of acute onset, and was diagnosed as having optic neuropathy by an ophthalmologist. It disappeared spontaneously within 2 months. A visual loss at the left side relapsed ten months later, followed by a dysarthria, horizontal defective saccade, ataxia, and mild weakness of four extremities, which also subsided within one month only by multi-vitamin therapy. These signs recurred episodically with characteristic clinical features of dysarthria, horizontal ophthalmoplegia, defective saccade, ataxia, and weakness, during the next year. Clinical features mimicked those of various neurological disorders, especially multiple sclerosis, Wernicke encephalopathy, brainstem encephalitis, Fisher syndrome, disorders of amino acid metabolism and episodic ataxia. Tablets of bromvalerylurea were incidentally found at the bedside and bromides were detected in his sera. Drugs containing bromides are now easily available without prescription, so we should keep the intoxications of those drugs in mind in facing undiagnosed patients with various episodic neurological symptoms.
一名28岁男性突发双侧视力丧失，眼科医生诊断为视神经病变。视力在2个月内自行恢复。10个月后左侧视力丧失复发，随后出现构音障碍、水平扫视缺陷、共济失调和四肢轻度无力，仅通过多种维生素治疗在1个月内也消退了。在接下来的一年里，这些症状反复发作，伴有构音障碍、水平眼肌麻痹、扫视缺陷、共济失调和无力等特征性临床表现。临床特征类似于各种神经系统疾病，尤其是多发性硬化症、韦尼克脑病、脑干脑炎、费希尔综合征、氨基酸代谢紊乱和发作性共济失调。床边偶然发现溴戊酰脲片，血清中检测到溴化物。含溴化物的药物现在无需处方即可轻易获得，因此在面对有各种发作性神经症状的未确诊患者时，我们应牢记这些药物中毒的情况。
