[A case of chronic bromvalerylurea intoxication with episodic neurological manifestations such as optic neuropathy ophthalmoplegia and ataxia].

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.