Avermectin intoxication with coma, myoclonus, and polyneuropathy, Clinical Toxicology, Informa Healthcare

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Avermectin intoxication with coma, myoclonus, and polyneuropathy

August 2009, Vol. 47, No. 7 , Pages 686-688

Yueh-Feng Sung¹, Chuang-Ti Huang², Cheng-Kuo Fan², Chih-Hung Lin², and Shiou-Ping Lin³

¹Department of Neurology, Tri-Service General Hospital, Taipei, Taiwan, Republic of China

²Department of Internal Medicine, Armed Force Hospital, Hsin Chu, Taiwan, Republic of China

³Physical Medicine and Rehabilitation, Armed Force Hospital, Hsin Chu, Taiwan, Republic of China

Address correspondence to Dr. Yueh-Feng Sung, Department of Neurology, Tri-Service General Hospital, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan, Republic of China Tel: (886-2)-8792-3311 ext 16875, Fax: (886-2)-8792-7174. E-mail: sungyf@ndmctsgh.edu.tw

Introduction. Avermectin has been used in the control of parasites and insects. Severe poisoning symptoms in humans include altered mental status, hypotension, and respiratory failure. Case report. We describe a case of acute avermectin intoxication at a very high dose (414.2 mg/kg) who presented with coma, myoclonus, and polyneuropathy after oral ingestion. Discussion. The symptoms are supposed to be associated directly with the avermectin poisoning and possibly with the toxicity of solvents or other additives. Conclusion. To the best of our knowledge, this is the first case with avermectin poisoning associated with myoclonus and polyneuropathy in the literature.