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Robert G. Feldman, MD; Roberta F. White, PhD; Ikechukwu I. Eriator, MD

Arch Neurol. 1993;50(12):1320-1324.

Abstract
A chemistry student was acutely exposed to vapors of an organotin compound. Seventy-two hours later, he exhibited delirium, spatial disorientation, perseveration, inappropriate affect, and memory defects. Five months later, he experienced episodes of complex partial seizures, which continue to require anticonvulsant medication after 7 years. Trimethyltin was identified in blood and urine samples taken 17 days after the accident; the blood level of trimethyltin was elevated 35 days after exposure. Serial electroencephalograms showed persistent left temporal paroxysmal epileptogenic potentials. Serial neuropsychological tests revealed persistent memory defects, cognitive dysfunction, and dysphoria 4 years after exposure. We review acute, resolving, and long-term residual neurotoxic effects of trimethyltin in man. We describe detailed clinical observations, serial neuropsychological test results, electroencephalographic findings, and exposure data in this patient, confirming the limbic system effects of trimethyltin and relating them to the known histopathologic pattern of this condition.

Author Affiliations
From the Occupational and Environmental Neurology Program, Department of Neurology, University Hospital and Boston (Mass) University School of Medicine (Drs Feldman, White, and Eriator); Department of Environmental Health, Boston University School of Public Health (Drs Feldman, White, and Eriator); Neurology and Psychology Services, Boston Veterans Affairs Medical Center (Drs Feldman and White); and Department of Psychiatry, Tufts University School of Medicine, Boston (Dr White).

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