Clinical analysis of longstanding subacute myelo-optico-neuropathy: sequelae of clioquinol at 32 years after its ban.
One thousand and thirty-one longstanding patients with subacute myelo-optico-neuropathy (SMON; 275 males, 756 females; mean age +/- S.D., 72.9 +/- 9.6 years; age at onset 37.6 +/- 9.8 years; duration of illness 35.3 +/- 4.0 years) were examined in 2002, 32 years after banning of clioquinol. At onset, 66.7% of patients were unable to walk, and 4.7% complete blindness. At present time, about 41% of patients were still difficult to walk independently, including 15.8% of completely loss of locomotion. One point six percent of patients were in complete blindness and 5.8% had severe visual impairment. The majority (95.6 - 97.7%) of patients exhibited sensory disturbances including superficial and vibratory sensations and dysesthesia. Dysautonomia was observed as leg hypothermia in 79.8%, urinary incontinence in 60.7%, and bowel disturbance in 95.3%. As complication, high incidence was revealed with cataract (56.2%), hypertension (40.2%), vertebral disease (35.5%), and limb articular disease (31.5%). These results indicate the serious sequelae of clioquinol intoxication, SMON.
Konagaya
Masaaki
M
Department of Neurology, Suzuka National Hospital, 3-2-1 Kasado, Suzuka, Mie 5138501, Japan. konagaya@suzuka.hosp.go.jp
Matsumoto
Akihisa
A
Takase
Sadao
S
Mizutani
Tomohiko
T
Sobue
Gen
G
Konishi
Tetsuro
T
Hayabara
Toshiyuki
T
Iwashita
Hiroshi
H
Ujihira
Takatoshi
T
Miyata
Kazuaki
K
Matsuoka
Yukihiko
Y
D000368:Aged; D000369:Aged, 80 and over; D000563:Amebicides / Q000009:adverse effects; D001342:Autonomic Nervous System Diseases / Q000209:etiology; D001766:Blindness / Q000209:etiology; D007464:Clioquinol / Q000009:adverse effects*; D015331:Cohort Studies; D004196:Disease Outbreaks; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009901:Optic Nerve Diseases / Q000139:chemically induced / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology*; D010525:Peripheral Nerves / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology*; D011446:Prospective Studies; D013116:Spinal Cord / Q000503:physiopathology; D016896:Treatment Outcome
D000563:Amebicides; D007464:Clioquinol