An 18-year-old man ingested 975 to 1,300 mg of potassium cyanide in a suicide attempt. He was treated and survived the poisoning episode, but then had severe parkinsonian syndrome, characterized primarily by akinesia and rigidity. He died 19 months after the drug overdose. At autopsy, major destructive changes were found in the globus pallidus and putamen, whereas the melanin-containing zone of substantia nigra was intact. This is the first clinicopathologic report of parkinsonism as a result of cyanide poisoning.
SUMMARY:Two patients had lumbosacral radiculopathy following radiation treatment of cancer. Twenty previously reported cases were similar. The clinical picture is one of progressive motor and sensory loss in the legs, usually appearing within a year after radiation, but sometimes delayed up to several years. Experimental studies quoted indicate greater vulnerability of peripheral nerves to ionizing radiation than has been previously recognized. Lumbo-sacral radiculopathy is readily produced in the experimental animal (rat) and affords an experimental model closely resembling the human cases reported.
Bilateral carpal tunnel syndrome is described in two sisters aged six and seven years, complicating the course of mucolipidosis III (pseudo-Hurler polydystrophy). The literature regarding carpal tunnel syndrome in childhood is reviewed with particular reference to diagnostic features and the association, in bilateral cases, with the mucopolysaccharidoses and mucolipidoses.
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