title: Pontine myelinolysis in a child with carbamate poisoning.
abstract: Carbamate and organophosphate pesticides are widely used all over the world. Poisoning with these substances may produce both immediate and delayed neurotoxic effects. We report the case of a 4-year-old boy who was admitted to the Pediatric Department of the Second University of Naples for evaluation of stupor, lethargy, severe hypotonia, generalized weakness of his arms and legs, ataxia, dysmetria, miosis, excessive salivation and tearing. The pesticide carbaryl (1-naphthyl-N-methylcarbamate) was identified in blood and urine samples. On admission, magnetic resonance imaging (MRI) was unremarkable; on day 11, MRI showed central pontine myelinolysis. The demyelination improved after 4 months and disappeared after 2 years. Various underlying and concomitant diseases have been described in children with central pontine myelinolysis but, to our knowledge, the finding of pontine myelinolysis after carbamate poisoning has not yet been described.
authors.affiliation: Department of Pediatrics, Second University of Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Santinelli
authors.forename: Carlo
authors.initials: C
authors.lastname: Tolone
authors.forename: Angelo
authors.initials: A
authors.lastname: D'Avanzo
authors.forename: Emanuele Miraglia
authors.initials: EM
authors.lastname: del Giudice
authors.forename: Laura
authors.initials: L
authors.lastname: Perrone
authors.forename: Michele
authors.initials: M
authors.lastname: D'Avanzo
mesh_terms: D012721:Carbaryl / Q000097:blood / Q000506:poisoning* / Q000652:urine; D002675:Child, Preschool; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D017590:Myelinolysis, Central Pontine / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D012721:Carbaryl