Accidental choke cherry poisoning: early symptoms and neurological sequelae of an unusual case of cyanide intoxication

Abstract

We report the case of a 56-year-old woman who was accidentally poisoned when she ingested choke cherries whose pulp contained cyanide, and describe the acute clinical picture, the neurological sequelae and the neuroradiological findings. After recovery from coma, the patient showed signs of a parkinsonian syndrome, retrobulbar neuritis and sensory-motor neuropathy. MRI showed abnormal signal intensities involving the basal ganglia. Since no memory deficits were observed, we argue that the parkinsonian syndrome was caused by cyanide intoxication rather than by subcortical damage due to hypoxia.

Sommario

Viene descritto un caso di una donna di 56 anni che ha manifestato un avvelenamento accidentale da cianuro dopo ingestione di bacche di laurino che contenevano cianuro nella polpa. Ne riportiamo il quadro clinico acuto, le sequele neurologiche e i reperti neuroradiologici. Dopo essersi ripresa dal coma, la paziente manifestò una sindrome parkinsoniana, neurite retrobulbare e neuropatia sensitivo-motoria. La RMN evidenziò aree di alterato segnale a livello dei gangli della base. La paziente non aveva disturbi di memoria per cui è possibile ipotizzare che la sindrome parkinsoniana sia stata causata dall'intossicazione da cianuro piuttosto che da un danno sottocorticale dovuto a ipossia.

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Pentore, R., Venneri, A. & Nichelli, P. Accidental choke cherry poisoning: early symptoms and neurological sequelae of an unusual case of cyanide intoxication. Ital J Neuro Sci 17, 233–235 (1996). https://doi.org/10.1007/BF01995689

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Key Words

  • Cyanide
  • Food ingestion poisoning
  • Retrobulbar neuritis
  • Peripheral neuropathy
  • Parkinsonism