Mercury toxicity following unauthorized siddha medicine intake – A mimicker of acquired neuromyotonia - Report of 32 cases

Gnanashanmugam, G; Ramasamy, Balakrishnan; Somasundaram, SP; Parimalam, N; Rajmohan, Priyanka; Pranesh, M B

doi:10.4103/aian.aian_274_17

Cited by 14 publications

(2 citation statements)

References 18 publications

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“…The pattern of exclusive CASPR2 antibody positivity (14 patients) being more common than the LGI‐1 positivity (5 patients), seen in this study, was as observed in other studies. In the single patient with mercury toxicity and CASPR2 positivity, the autoimmunity was probably triggered by the mercury toxicity, as has been described 10 . Seronegativity was associated with prominent central features and poor outcomes, as has been previously noted 11,12 .…”

Section: Discussionsupporting

confidence: 60%

Acquired hyperexcitable peripheral nerve disorders: Clinical and laboratory features, therapeutic responses, and long‐term follow‐up

Khadilkar,

Pandya,

Dhonde

et al. 2023

Muscle and Nerve

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Introduction/AimsHyperexcitable peripheral nerve disorders (HPNDs) are rare. Although their clinical and laboratory features have been well studied, information on treatment and follow‐up is limited. The aim of this study is to explore the long‐term clinical, investigative, and therapeutic profile of patients with acquired HPNDs.MethodsThis study retrospectively analyzed patients from a single tertiary care center with HPND (January 2012 to January 2022). Patients were recruited according to published inclusion and exclusion criteria. Details of clinical features, diagnostic tests, therapeutic interventions, and follow‐up were recorded. This study included patients with follow‐up of 2 or more years.ResultsA total of 32 patients (M = 26, F = 6) were studied. The common clinical features included myokymia, neuropathic or shock‐like pain, cramps, sleep disturbances, encephalopathy, cerebellar ataxia, and seizures. A total of 81.25% of patients responded favorably to corticosteroids and membrane stabilizers. Among the nonresponders, five received intravenous immunoglobulin (IVIG), and one received plasma exchange (PLEX). Two patients required rituximab due to poor responses to the above treatments. The mean duration of response was 6 weeks (4–24 weeks) from the initiation of treatment. All patients had favorable outcomes, reaching clinical remission within 1–5 years from the initiation of treatment. Only two patients had relapses. Immunotherapy could be stopped in 78% of patients within 3 years and 100% by 5 years.DiscussionChronic immunosuppression starting with corticosteroids is required for satisfactory outcomes of HPNDs. These disorders usually run a monophasic course, and relapses are uncommon.

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Section: Discussionsupporting

confidence: 60%

Acquired hyperexcitable peripheral nerve disorders: Clinical and laboratory features, therapeutic responses, and long‐term follow‐up

Khadilkar,

Pandya,

Dhonde

et al. 2023

Muscle and Nerve

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“…Mercury Toxicity following Unauthorized Siddha Medicine Intake -A mimicker of Acquired Neuromyotonia -Report of 32 Cases says [12] Mercury toxicity following Siddha medicine intake closely mimics acquired Neuromyotonia, severe intolerable neuropathic pain, predominantly involving lower limbs.…”

Section: Casementioning

confidence: 99%

A comprehensive and detailed review on Mercury Toxicity

Manpreetkaur K. Gaur,

Kalpana R. Chavhan

2023

J Ayurveda Integr Med Sci

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Introduction: Mercury is a chemical element with the symbol Hg and atomic number 80. It is also known as quicksilver and was formerly named hydrargyrum. In Ayurveda, use of Mercury in Rasa-Aushadhis has been known to all of us since the era of Nagarjuna who experimented with mercury with intention to eliminate poverty from world. With proper use of mercury in medicinal formulations diseases can be cured but their improper use can lead to various diseases such as Nasabhanga, Mukhroga, Pakshaghat, Twacha Vaivarnya, Unmad and other psychic disorders and can lead to Toxicity. Mercury is an Irritant Inorganic Metal Poison. Metallic mercury is not poisonous when taken by mouth. Poisoning occurs if the finely divided particles or vaporized mercury is swallowed, inhaled or rubbed on the skin. Material & Methods: Various Samhita Granthas, Articles, Textbooks related to Mercury Toxicity were studied. Results & Conclusion: Wide use of Mercury in Ayurvedic & Siddha medicines is evident since many years. As mercury gets deposited in tissues, it can lead to toxicity as a chronic effect. Also, occupational exposure by means of inhalation of vapors can cause many symptoms such as conjunctivitis, stomatitis, cough, dyspnoea, etc. Case studies also reported how Mercury toxicity can affect CVS, Respiratory & CNS systems. PM Appearances, Medicolegal aspect, Treatment, of Mercury Toxicity and Ayurvedic description were discussed.

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Methylmercury induces hyperalgesia/allodynia through spinal cord dorsal horn neuronal activation and subsequent somatosensory cortical circuit formation in rats

2021

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Mercury toxicity following unauthorized siddha medicine intake – A mimicker of acquired neuromyotonia - Report of 32 cases

Cited by 14 publications

References 18 publications

Acquired hyperexcitable peripheral nerve disorders: Clinical and laboratory features, therapeutic responses, and long‐term follow‐up

Acquired hyperexcitable peripheral nerve disorders: Clinical and laboratory features, therapeutic responses, and long‐term follow‐up

A comprehensive and detailed review on Mercury Toxicity

Methylmercury induces hyperalgesia/allodynia through spinal cord dorsal horn neuronal activation and subsequent somatosensory cortical circuit formation in rats

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