Journal List > Korean J Clin Neurophysiol > v.15(2) > 1084123

Kim, Kim, Kwon, Kim, and Jung: Multiple Cranial Neuropathy and Polyradiculoneuropathy as Delayed Sequelae of Ethylene Glycol Intoxication

Abstract

Multiple cranial and peripheral neuropathies as a delayed sequellae of ethylene glycol poisoning is a less well known clinical entity and its information about long-term electrophysiological and clinical outcomes is limited. We report a 45-year-old male who presented with acute renal failure and subsequently developed multiple cranial neuropathy, respiratory failure, and flaccid tetraparesis. Through sequential electrophysiological studies, we would like suggest that the main pathophysiology of ethylene glycol-related neuropathy is a demyelinating polyradiculoneuropathy with secondary axonal degeneration.

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Figure 1.
Serial motor-conduction study findings for the peroneal and tibial nerves in the patient. (A, C) Conduction block is present between the ankle and knee. (B, D) Follow-up study suggested a secondary axonal degeneration.
kjcn-15-63f1.tif
Table 1.
Sequential electrophysiological study of the patient
Examination date (days after admission) 18 days 52 days 91 days 119 days
Motor (Right)
Median Amplitude (Wrist/Elbow), mV 15.4/14.6 14.6/14.2 10.5/9.3 10.1/9.8
Distal latency, msec 4.29 3.75 4.08 4.08
Velocity (Wrist-Elbow), m/sec 53.4 59.4 55.3 51.7
F-latency, msec 33.15 - 31.75 30.85
Ulnar Amplitude (Wrist/Elbow), mV 19.4/18.2 18.2/15.2 14.9/13.5 14.4/13.0
Distal latency, msec 4.77 2.64 2.7 2.67
Velocity (Wrist-Elbow), m/sec 43.0 57.6 49.4 47.1
F-latency, msec 36.2 - 32.6 32.6
Peroneal Amplitude (Ankle/Fibular head), mV 2.27/1.71 4.77/3.33 1.47/0.36* 0.2/0.052*
Distal latency, msec 4.77 4.35 5.3 6.05
Velocity (Ankle-Fibular head), m/sec 40.5 41.6 30.8 33.8
F-latency, msec - - - -
Tibial Amplitude (Ankle/Popliteal fossa), mV 16.66/11.62 15.28/13.22 6.27/2.58* 3.05/1.43*
Distal latency, msec 4.29 4.71 6.15 6.09
Velocity (Ankle-Popliteal fossa), m/sec 40.0 40.4 29.4 33.4
F-latency, msec 53.2 - - -
H-latency (Right/Left) -/- -/- -/- -/-
Sensory (Right)
Median Amplitude (Wrist/Elbow), μV 21.8/20.7 18.9/25.8 28.0/23.8 22.6/26.6
Velocity (Finger-Wrist/Wrist-Elbow), m/sec 40.1/50.0 50.7/58.9 43.4/49.2 43.0/51.5
Ulnar Amplitude (Wrist/Elbow), μV 13.1/14.9 16.1/22.7 10.4/16.2 10.8/16.9
Velocity (Finger-Wrist/Wrist-Elbow), m/sec 35.9/49.8 47.9/56.5 45.9/48.2 45.3/46.7
Sural Amplitude, μV 8.0 13.30 6.10 -
Velocity, m/sec 35.1 38.0 28.2 -

* conduction block was seen.

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