Stork C M, Cantor R
Central New York Poison Control Center, University Hospital, SUNY HSC at Syracuse 13210, USA.
J Toxicol Clin Toxicol. 1997;35(1):105-8. doi: 10.3109/15563659709001175.
Pemoline is an oxazolidine derivative that is structurally different from amphetamines and used in the treatment of attention deficit disorder. Pemoline has not been commonly associated in the literature as a cause of acute movement disorders. The following case describes two children acutely poisoned with pemoline who experienced profound choreoathetosis.
Two, 3-year-old male, identical twin siblings presented to the emergency department after found playing with a an empty bottle of pemoline originally containing 59 tablets. The children had a medical history significant for attention deficit disorder previously treated with methylphenidate without success. This was their first day of pemoline therapy. The choreoathetoid movements began 45 min to 1 h after ingestion. The children gave no history of prior movement disorders and there was no family history of movement disorders. The children received gastrointestinal decontamination and high doses of intravenous benzodiazepines in an attempt to control the choreoathetoid movements. Despite treatment, the children continued to have choreoathetosis for approximately 24 hours. Forty-eight hours after admission, the children appeared to be at their baseline and were discharged home.
Pemoline associated movement disorder has been rarely reported in the acute toxicology literature. The possibility of choreoathetoid movements should be considered in patients presenting after pemoline overdose.
匹莫林是一种恶唑烷衍生物，其结构与苯丙胺类不同，用于治疗注意力缺陷障碍。在文献中，匹莫林作为急性运动障碍的病因并不常见。以下病例描述了两名因匹莫林急性中毒而出现严重舞蹈手足徐动症的儿童。
两名3岁男性同卵双胞胎兄弟在被发现玩弄一个原本装有59片匹莫林的空药瓶后被送往急诊科。这两名儿童有注意力缺陷障碍病史，此前使用哌甲酯治疗无效。这是他们接受匹莫林治疗的第一天。舞蹈手足徐动症在摄入药物后45分钟至1小时开始出现。这两名儿童既往无运动障碍病史，家族中也无运动障碍病史。为控制舞蹈手足徐动症，这两名儿童接受了胃肠道去污治疗，并静脉注射了大剂量苯二氮䓬类药物。尽管进行了治疗，这两名儿童的舞蹈手足徐动症仍持续了约24小时。入院48小时后，这两名儿童似乎恢复到了基线状态并出院回家。
匹莫林相关的运动障碍在急性毒理学文献中鲜有报道。匹莫林过量中毒的患者应考虑出现舞蹈手足徐动症的可能性。
