Clinical History
Longstanding extrapyramidal symptoms
Imaging Findings
The patient with a history of longstanding exposure to organic phosphorus compounds used in agriculture,had extrapyramidal symptoms. An MRI was performed. Changes in the putamina, caudate nuclei, and in the parietooccipital cortices were noted, consistent with chronic organic phosphorus intoxication.
Discussion
Causes of bilateral basal ganglia lesions include a number of toxic, metabolic, and degenerative conditions. These mainly comprise carbon monoxide, hydrogen sulfide, cyanide poisonings, and others; barbiturate, methanol, thinner, and trichloroethane intoxications, and hypoglycemia; Leigh’s disease, Wilson’s disease, mitochondrial encephalopathy, strial degeneration, and Hallervorden-Spatz disease.
Differential Diagnosis List
Chronic organic phosphorus intoxication
Final Diagnosis
Chronic organic phosphorus intoxication
