Myoclonic encephalopathies induced by bismuth salts. 6 cases observed during long-term oral treatment
Buge, A.; Rancurel, G.; Poisson, M.; Dechy, H.
La Nouvelle Presse Medicale 3(36): 2315-2320
1974
ISSN/ISBN: 0301-1518 PMID: 4218313 Document Number: 5532
Six patients who had been orally taking bismuth subnitrate for long time with important but classical daily doses, developed an acute severe encephalopathy. The strikely stereotyped neurological syndrome was characterized by confusion and/or stupour, diffuse myoclonis jerks, predominantly localized to members occurins spontaneous by but striking in the action with pseudo intentional tremor and clumsiness of superior members, gait disturbance and inhability to walk, dysarthria slow bilateral and aspecific electric anomalies without correspondence to the clinical symptoms. The syndrome regressed when the intake of bismuth was stopped but with particular fluctuations in the degree of signs from day to day. On blood and urines investigations, were found at first very high and significant rates of bismuth metal, then a decrease correlated to clinical improvement. Such serious but reversible toxic encephalopathies are undoubtely different from the effects of soluble parenteral bismuth treatments, and unkwown until last nouths with insoluble bismuth when administrated by mouth. All patients were extensively investigated and no metabolic disturbances could be found. All of them had suffered chronic colopathy with inremitting constipation and radiological aspects of dolichomegacolon.
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