@article{ref1,
title="Acute toxic encephalopathy following bromadiolone intoxication: a case report",
journal="BMC neurology",
year="2021",
author="Mao, Ning and Wang, Jin-Qiu and Qu, Yun and Yu, Wei and Li, Quan and Kang, Hai",
volume="21",
number="1",
pages="e8-e8",
abstract="BACKGROUND: Clinically, bromadiolone poisoning is characterized by severe bleeding complications in various organs and tissues. Bromadiolone-induced toxic  encephalopathy is extremely rare. Here, we report a special case of  bromadiolone-induced reversible toxic encephalopathy in a patient who had  symmetrical lesions in the deep white matter. CASE PRESENTATION: A 23-year-old woman  mainly presented with dizziness, fatigue, alalia and unsteady gait after the  ingestion of bromadiolone. The laboratory examinations showed normal coagulation  levels. Brain magnetic resonance imaging (MRI) showed apparent diffusion restriction  in the bilateral deep white matter. The clinical manifestations and MRI alterations  were reversible within one month of treatment with vitamin K. The neuropsychological  assessment showed no neurodegenerative changes at the 2-year follow-up. <br><br>CONCLUSION:  With the increased use of bromadiolone as a rodenticide, more cases of ingestion  have been reported annually over the past several years. Bromadiolone-induced toxic  encephalopathy has no special clinical manifestations and is potentially reversible  with timely treatment. Because of the reversible restricted diffusion on  diffusion-weighted images (DWI) and low apparent diffusion coefficient (ADC) values,  transient intramyelinic cytotoxic oedema is thought to be the cause rather than  persistent ischaemia. The underlying pathophysiological mechanism is still unknown  and may be coagulant-independent. This clinical case extends the current knowledge  about neurotoxicity in cases of bromadiolone poisoning and indicates that MRI is  useful for the early detection of bromadiolone-induced toxic encephalopathy.<p /> <p>Language: en</p>",
language="en",
issn="1471-2377",
doi="10.1186/s12883-020-02034-2",
url="http://dx.doi.org/10.1186/s12883-020-02034-2"
}