US EPA

1358361 

Journal Article 

Psychosis Following Arsenic (Possibly Thallium) Poisoning 

Schenk, VWD; Stolk, PJ 

1967 

0 

Psychiatria
ISSN: 0113-423X 

NIOSH/00132594 

70 

1 

31-37 

A case of a female suffering from psychosis resulting from arsenic (7440382) poisoning was reported. The 56 year old subject was admitted to a neurological clinic with massive hair loss, abdominal pain, and impaired vision. She had paresthesia, reduced strength in limbs, and soft and indistinct speech. Vision was reduced to light perception and legs were paretic and painful. Urine tests were performed for thallium (7440280) and arsenic, and were positive for arsenic. The presence of arsenic in the fingernails was also verified. Leg strength gradually returned and hair growth was also restored. Both optic nerves atrophied completely. The patient suffered from hysterical and restless behavior, with hallucinations and paranoid thinking. She became increasingly incoherent. Diagnosis was organic psychosis. The patient died after 19 years and an autopsy was performed. General atrophy of the cerebral cortex was seen, and was most pronounced in the dorsal parts of the hemispheres. Dentate nuclei showed loss of cells with an increase of glia, which was also seen in the cerebellar medulla and the red nucleus. Both inferior olives showed symmetrical loss of ganglion cells and fibers with swollen dendrites. There was virtually complete destruction of the optic nerve cells in the internal retinal layer. All nerve fibers had disappeared. No myelin sheaths and only a few axons were found in the optic nerve. The authors conclude that failure to demonstrate thallium does not imply that thallium was not present in the pesticide with which the patient was poisoned. The neurological changes, blindness, and alopecia exhibited by this case are symptoms of thallium, rather than arsenic, poisoning. 

DCN-122720; Clinical symptoms; Toxic effects; Physiological response; Biological effects; Poisons; Clinical diagnosis; Cytotoxic effects; Biological factors; Neurological reactions