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Disulfiram neuro-toxicity: a review and report of a case of fluctuating neuro-encephalopathy

Published online by Cambridge University Press:  13 June 2014

Marcus Webb
Marcus Webb*
Affiliation:
Trinity College, University of Dublin, and St. James's Hospital, Dublin 8
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Abstract

A case of chronic disulfiram (Antabuse) toxicity is described, in the context of a literature review, apparently the first such description from Ireland. The rare combination of encephalopathy with peripheral neuropathy occurred in this case, along with other probably related features. These included a fluctuating clinical course, cerebellar ataxia, grand mal seizures, impotence and a delay in improvement on discontinuing disulfiram. It is likely that symptoms of anxiety and depression in this man were also in part induced by disulfiram toxicity, but interpretation of events is complicated by developing arteriosclerosis. The difficulties in distinguishing toxic effects of disulfiram from complications of chronic alcoholism are emphasized, with resulting delay in recognizing disulfiram toxicity.

Keywords

Disulfirambrain diseasesperipheral nerve diseasescerebellar diseasesimpotencechronic alcoholismfluctuating clinical course.
Type
Clinical and Brief Reports
Information
Irish Journal of Psychological Medicine , Volume 8 , Issue 1 , March 1991 , pp. 51 - 54
Copyright
Copyright © Cambridge University Press 1991

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References

1.Hald, J, Jacobsen, E, Larsen, V. The sensitizing effect of tetraethylthiuramdisulfide (Antabuse) to ethyl alcohol. Acta Pharmacol Toxicol 1948; 4: 285–296.CrossRefGoogle Scholar
2.Mokri, B, Ohnishi, A, Dyck, PJ. Disulfiram neuropathy. Neurology 1981; 31: 730–735.CrossRefGoogle ScholarPubMed
3.Van Rossum, J, Roos, RAC, Bots, GTAM. Disulfiram polyneuropathy. Clin Neurol Neurosurg 1984; 86: 81–87.CrossRefGoogle ScholarPubMed
4.Frisoni, GB, Di Monda, V. Disulfiram neuropathy: a review (1971-1988) and report of a case. Alcohol and Alcoholism 1989; 24: 429–437.Google ScholarPubMed
5.Knutsen, B. Komplikasjoner ved antabus-behandling. Tidsskrift for den Norske Laegeforening 1949; 69: 436–437.Google Scholar
6.Liddon, SC, Satran, R. Disulfiram (Antabuse) psychosis. Am J Psychiatry 1967; 123: 1284–1289.CrossRefGoogle ScholarPubMed
7.Knee, ST, Razani, J. Acute organic brain syndrome: a complication of disulfiram therapy. Am J Psychiatry 1974; 131: 1281–1282.Google ScholarPubMed
8.Gardner-Thorpe, C, Benjamin, S. Peripheral neuropathy after disulfiram administration. J Neurol Neurosurg Psychiatry 1971; 34: 253–259.CrossRefGoogle ScholarPubMed
9.Lamperiere, T, Ades, J, Hardy, P. Complications neuro-psychiques des traitements au disulfiram. A propos d'une observation. Annales Medico-psychologique 1982; 140: 123–129.Google Scholar
10.Borrett, D, Ashby, P, Bilbao, J, Carlen, P. Reversible, late-onset disulfiram-induced neuropathy and encephalopathy. Ann Neurol 1985; 17: 396–399.CrossRefGoogle ScholarPubMed
11.Graveleau, J, Ecoffet, M, Villard, A. Les neuropathies peripheriques dues au disulfiram. Nouvelle Presse Medicale 1980; 9: 2905–2907.Google ScholarPubMed
12.Sahenk, Z. Toxic neuropathies. In: Goldblatt, D, ed. Seminars in neurology; vol 7. New York: Theme Medical Publishers, 1987: 13.Google Scholar
13.Wise, JD. Disulfiram toxicity – a review of the literature. J Arkansas Med Soc 1981; 78: 87–92.Google ScholarPubMed
14.Dyck, PJ, Thomas, PK, Lambert, EH, Bunge, R. Peripheral Neuropathy. 2nd ed. Philadelphia: W.B.: Saunders, 1984; 2164.Google Scholar
15.Watson, CP, Ashby, P, Bilbao, JM. Disulfiram neuropathy. Can Med Assoc J 1982; 123: 123–126.Google Scholar
16.Ansbacher, LE, Bosch, EP, Cancilla, PA. Disulfiram neuropathy: a neurofilamentous distal axonopathy. Neurology 1982; 32: 424–428.CrossRefGoogle ScholarPubMed
17.Hotson, JR, Langston, JW. Disulfiram-induced encephalopathy. Arch Neurol 1976; 33: 141–142.CrossRefGoogle ScholarPubMed
18.Price, TRP, Silberfarb, PM. Disulfiram-induced convulsions without challenge by alcohol. J Stud Ale 1976; 37: 980–982.Google ScholarPubMed
19.Ellingwood, EH Jr, Sudilovisky, A, Grabowy, R. Olfactory forebrain seizures induced by methamphetamine and disulfiram. Biol Psych 1973; 7: 89–99.Google Scholar
20.Palliyath, S, Schwartz, BD. Disulfiram neuropathy: electrophysiological study. Electromyogr Clin Neurophysiol 1988; 28: 245–247.Google ScholarPubMed
21.Palliyath, SK, Schwartz, BD, Gant, L. Peripheral nerve functions in chronic alcoholic patients on disulfiram: a six-month follow up. J Neurol Neurosurg Psychiatry 1990; 53: 227–230.CrossRefGoogle ScholarPubMed
22.Worner, TM. Peripheral neuropathy after disulfiram administration: reversibility despite continued therapy. Drug Alcohol Depend 1982; 10: 199–201.CrossRefGoogle ScholarPubMed
23.Lishman, A. Organic Psychiatry. Blackwell Scientific Publications; 1987.Google Scholar
24.LeQuesne, PM. Neuropathy due to drugs. In: Dyck, PJ, Thomas, PK, Lambert, EH, eds. Peripheral neuropathy; vol II. Philadelphia: W.B. Saunders, 1975; 1267–1269.Google Scholar