Neuropsychological, neuroimaging and autopsy findings of butane encephalopathy

BMC Neurology

Case Report

Suk Sung¹  Gi Yeong Huh²  Jaeseob Yun³  Sung Hwan Jang³  Huiran Cho³  Myung Jun Lee³  Eun-Joo Kim³  Na-Yeon Jung⁴  Jin-Hong Shin⁴  Jae-Hyeok Lee⁴  Junkyeung Ko⁵  Jae Meen Lee⁵  Kyoungjune Pak⁶  Kyung-Un Choi⁷  Jae Woo Ahn⁷  Chungsu Hwang⁷  Young Min Lee⁸  Jin A Yoon⁹ 

[1] Department of Anatomy, Pusan National University School of Medicine, Yangsan, Republic of Korea;Department of Forensic Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea;Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, 179, Gudeok-ro, Seo-gu, 49241, Busan, Republic of Korea;Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea;Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea;Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea;Department of Nuclear Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea;Department of Pathology, Pusan National University School of Medicine, Yangsan, Republic of Korea;Department of Psychiatry, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea;Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Republic of Korea;

关键词: Butane;    Encephalopathy;    Neuropsychology;    Neuroimaging;    Autopsy;   

DOI  :  10.1186/s12883-023-03278-4

 received in 2023-02-08, accepted in 2023-06-06,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundButane is an aliphatic hydrocarbon used in various commercial products. While numerous reports of sudden cardiac-related deaths from butane inhalation have been described, butane-associated acute encephalopathy has rarely been reported.Case presentationA 38-year-old man presented with cognitive dysfunction after butane gas inhalation. Neuropsychological test results showed impairments in verbal and visual memory, and frontal executive function. Diffusion weighted MRI revealed symmetric high-signal changes in the bilateral hippocampus and globus pallidus. FDG-PET demonstrated decreased glucose metabolism in the bilateral precuneus and occipital areas and the left temporal region. At the 8-month follow-up, he showed still significant deficits in memory and frontal functions. Diffuse cortical atrophy with white matter hyperintensities and extensive glucose hypometabolism were detected on follow-up MRI and FDG-PET, respectively. Brain autopsy demonstrated necrosis and cavitary lesions in the globus pallidus.ConclusionsOnly a few cases of butane encephalopathy have been reported to date. Brain lesions associated with butane encephalopathy include lesions in the bilateral thalamus, insula, putamen, and cerebellum. To the best of our knowledge, this is the first report on bilateral hippocampal and globus pallidal involvement in acute butane encephalopathy. The pathophysiology of central nervous system complications induced by butane intoxication is not yet fully understood. However, the direct toxic effects of butane or anoxic injury secondary to cardiac arrest or respiratory depression have been suggested as possible mechanisms of edematous changes in the brain after butane intoxication.

【 授权许可】

CC BY   
© The Author(s) 2023

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