Diffuse white matter lesions in carbon disulfide intoxication: Microangiopathy or demyelination

Mei Chuan Ku, Chin Chang Huang, Hung Chou Kuo, Tzu Chen Yen, Chi Jen Chen, Tung Sheng Shih, Ho Yuan Chang

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Long-term exposure to carbon disulfide (CS2) may induce diffuse encephalopathy with parkinsonism, pyramidal signs, cerebellar ataxia, and cognitive impairments, as well as axonal polyneuropathy. The pathogenic mechanisms of diffuse encephalopathy are unclear, although vasculopathy and toxic demyelination have been proposed. Recently, we have encountered a patient who developed headache, limb tremors, gait disturbance, dysarthria, memory impairment, and emotional lability after long-term exposure to CS2. The brain magnetic resonance images (MRI) showed diffuse hyperintensity lesions in T2-weighted images in the subcortical white matter, basal ganglia, and brain stem. The brain computed tomography perfusion study revealed a diffusely decreased regional cerebral blood flow and prolonged regional mean transit time in the subcortical white matter and basal ganglion. To our knowledge, there have been few reports demonstrating diffuse white matter lesions in chronic CS2 encephalopathy using brain MRI. In addition, the 99mTc-TRODAT-1 single photon emission computed tomography showed a normal uptake of the dopamine transporter, indicating a normal presynaptic dopaminergic pathway. We conclude that diffuse white matter lesions may develop after chronic exposure to CS2, possibly through microangiopathy. In addition, CS2 poisoning can be considered as one of the causes of chronic leukoencephalopathy.

Original languageEnglish
Pages (from-to)220-224
Number of pages5
JournalEuropean Neurology
Volume50
Issue number4
DOIs
Publication statusPublished - 2003
Externally publishedYes

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Keywords

  • Carbon disulfide
  • Demyelination
  • Dopamine transporter
  • Magnetic resonance imaging
  • Microangiopathy
  • Neurotoxic disease
  • TRODAT-1 single photon emission computed tomography

ASJC Scopus subject areas

  • Clinical Neurology

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