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Axonal Polyneuropathy After Acute Dimethylamine Borane Intoxication
Hung-Chou Kuo, MD;
Chin-Chang Huang, MD;
Chun-Che Chu, MD;
Nai-Shin Chu, MD, PhD
Arch Neurol. 2006;63:1009-1012.
Objective To study a patient with axonal polyneuropathy due to acute dimethylamine borane (DMAB) intoxication.
Patient Confusion and drowsiness in the acute stage, followed by cognitive impairments and polyneuropathy, are reported in a chemical factory worker after acute exposure to DMAB.
Results Nerve conduction studies indicated axonal polyneuropathy, particularly in the motor nerves. Sural nerve biopsy studies 3 months later revealed an axonal degeneration with a mild decrease of fiber density in the large myelinated fibers. Quantitative sensory testing also disclosed an impairment of pinprick, temperature, and touch sensations. Cutaneous nerve biopsy studies 9 months later demonstrated a moderate loss of epidermal nerves. During the follow-up period of 1.5 years, the clinical features and serial nerve conduction studies showed a steady improvement.
Conclusions Since DMAB is a new product and has been widely used recently in the manufacturing of semiconductors and electronics, we conclude that DMAB intoxication may produce motor-predominant axonal polyneuropathy and that the establishment of a threshold limit value is warranted.
Author Affiliations: Department of Neurology, Chang Gung Memorial Hospital and University, Taipei, Taiwan.
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