A Case of Optic Neuropathy Associated with Methyl Bromide Intoxication.

Shin, Hyun Uk; Kim, Jong Kuk; Yoon, Byeol A; Ryu, Won Yeol

doi:2016.57.12.1987

J Korean Ophthalmol Soc > Volume 57(12); 2016 > Article

Case Report

Journal of the Korean Ophthalmological Society 2016;57(12):1987-1993.
DOI: https://doi.org/10.3341/jkos.2016.57.12.1987 Published online December 15, 2016.

A Case of Optic Neuropathy Associated with Methyl Bromide Intoxication.

Hyun Uk Shin, Jong Kuk Kim, Byeol A Yoon, Won Yeol Ryu

¹Department of Ophthalmology, Dong-A University College of Medicine, Busan, Korea. wyryu@dau.ac.kr
²Department of Neurology, Dong-A University College of Medicine, Busan, Korea.

메틸브로마이드 유발 독성 시신경병증 1예

신현욱¹⋅김종국²⋅윤별아²⋅류원열¹

동아대학교 의과대학 안과학교실¹, 동아대학교 의과대학 신경과학교실²

Abstract

PURPOSE
In this study, a case of toxic encephalopathy and optic neuropathy due to methyl bromide poisoning is reported. CASE SUMMARY: A 31-year-old male presented with dysarthria, gait disturbance and bilateral visual impairment. He was treated with intravenous methylprednisolone for bilateral optic neuritis 1 year prior. He previously worked in a fumigation warehouse and was exposed to methyl bromide in the past 3 years. His corrected visual acuity was 20/30 in both eyes. The patient had reduced color vision and enlarged central scotoma in both eyes. His mentality was alert but exhibited slow response, ataxia and dysarthria. Brain magnetic resonance imaging (MRI) revealed high signals in the brainstem, cerebellum and midbrain. His serum and urine methyl bromide concentrations were significantly elevated. The patient was treated with intravenous methylprednisolone 1.0 g/day for 5 days. MRI showed resolution of the multiple brain lesions observed previously. Ten days after steroid therapy, his visual acuity was 20/20 in both eyes and his neurologic manifestations were completely recovered at 2 months after treatment. CONCLUSIONS: Taking a detailed occupational history is necessary in patients with optic neuropathy. The probability of toxic optic neuropathy should be considered when patients are exposed to toxic materials.

Key Words: Methyl bromide intoxication;Methyl bromide poisoning;Secondary optic neuropathy;Toxic encephalopathy;Toxic optic neuropathy