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Magnetic Resonance Imaging and Clinical Features of Chlorfenapyr-Induced Toxic Leukoencephalopathy: A Case Report

클로르페나피르 중독에 의한 백색질뇌증 환자의 임상양상과 자기공명영상 소견: 증례 보고

  • Jong Hyuk Kim (Department of Radiology, Myongji Hospital, Hanyang University College of Medicine) ;
  • Noh Hyuck Park (Department of Radiology, Myongji Hospital, Hanyang University College of Medicine) ;
  • Ji Yeon Park (Department of Radiology, Myongji Hospital, Hanyang University College of Medicine) ;
  • Seon-Jeong Kim (Department of Radiology, Myongji Hospital, Hanyang University College of Medicine)
  • 김종혁 (한양대학교 의과대학 명지병원 영상의학과) ;
  • 박노혁 (한양대학교 의과대학 명지병원 영상의학과) ;
  • 박지연 (한양대학교 의과대학 명지병원 영상의학과) ;
  • 김선정 (한양대학교 의과대학 명지병원 영상의학과)
  • Received : 2019.08.01
  • Accepted : 2019.10.18
  • Published : 2020.07.01

Abstract

Chlorfenapyr is widely used as an insecticide, despite it being fatal to humans. However, chlorfenapyr-induced central nervous system toxicity has rarely been reported. We report the magnetic resonance imaging (MRI) findings in a rare case of chlorfenapyr-induced toxic leukoencephalopathy. A 71-year-old man who had ingested chlorfenapyr approximately two weeks prior visited our hospital and presented with bilateral lower motor weakness and voiding dysfunction that had developed two days before admission. Brain MRI revealed extensive bilateral white matter abnormalities involving the corpus callosum, internal capsule, brain stem, and bilateral middle cerebellar peduncle. Furthermore, spine MRI revealed diffuse swelling and hyperintensity on the T2-weighted images.

클로르페나피르는 널리 사용되는 살충제이며 인간에게는 치명적일 수 있다. 그러나 중추신경계 침범을 동반한 클로르페나피르 중독은 거의 보고되지 않고 있다. 우리는 이전까지 드물게 보고된 클로르페나피르 중독에 의한 백질뇌병증 환자의 자기공명영상 소견을 보고하고자 한다. 약 2주 전에 클로르페나피르를 음독한 71세 남자 환자가 내원 2일 전부터 시작된 양측 하지위약감과 배뇨장애를 주소로 내원하였다. 시행한 뇌 자기공명영상에서는 뇌량, 속섬유막, 뇌줄기를 포함하는 영역에 양측성의 광범위한 뇌백질의 이상을 보였고, 척수 자기공명영상에서는 전반적인 척수에 고신호를 동반한 종창을 보였다.

Keywords

References

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