Severe Peripheral Neuropathy after Exposure to Monosodium Methyl Arsonate

Abstract

A case of severe peripheral neuropathy after several days of exposure to a pesticide spray containing monosodium methyl arsonate (MSMA) is reported. The clinical manifestations of symmetrical peripheral neuropathy with stocking-glove sensory deficit, decreased position sense, decreased and absent deep tendon reflexes, and muscle wasting are consistent with those described in other cases of arsenic intoxication. The anemia, leukopenia, and bone marrow changes of dyserythropoiesis in this case are also similar to those previously described with arsenic intoxication. The authors discuss the possible contribution of toxicity from exposure to other pesticides.

Good Outcomes Despite High Urinary Arsenic Concentrations from Overdose with Crabgrass Killer

“…Unlike our cases, Shum et al [2] described transient renal insufficiency which may have been more the result of volume depletion since recovery was rapid. Similar to our cases, no deaths occurred, and all patients seemed to have completely recovered with one exception: Hessl et al described persistent peripheral neuropathy [3] after a prolonged dermal exposure. Our index case developed transient subjective neuropathy.…”

“…Animal studies extrapolated to humans have estimated a low order of toxicity [1], but little information is available regarding overdose in humans. Previous reports have described oral exposures with less concentrated formulations of MSMA herbicides [2] or via dermal absorption [3]. Because of the limited information in the current literature, concern exists regarding exposures to concentrated forms of organic arsenic.…”

Inadvertent poisoning of seven teenagers with monosodium methanearsonate

“…12 He reported several weeks of GI distress and then developed shooting pains in the lower extremities and a 40-pound weight loss. He was found to have muscle wasting in the hands, an abnormal gait, anemia, leucopenia, and hematuria.…”

Organic Arsenical Exposure Stimulates Atherosclerosis Through Oxidative Stress Increase and Adhesion Molecule Expression

“…Humans are exposed to the toxicity of arsenic mainly via drinking water and anthropogenic activities. It is evident that various side effects of MSMA has been described in earlier studies which include hepatocellular damage, renal toxicity, neurological problems as well as skin problems (Hessl and Berman, 1982;De Capitani et al, 2005;Yao et al, 2013;Casale et al, 2014). Atherosclerotic disorders have been linked to lipid peroxidation (Kei, 1978).…”