背景:在吡虫啉的普遍部署中,这种化合物中毒的发生率明显上升。那些患有吡虫啉中毒的人通常表现出头痛等症状,头晕,恶心,还有腹痛,意识受损和呼吸困难,然而,这种毒素引起的眼麻痹的实例以前没有被记录。
方法:当杀虫剂喷雾无意中接触到患者的眼睛时,他们感到灼热和不适。在这一事件之后,第二天,这个人的右眼开始出现复视,并发现抬起眼睑很困难,这表明在实现全面扩展方面存在挑战。
方法:根据病史,症状,和标志,患者被诊断为吡虫啉引起的动眼神经麻痹。
方法:治疗方法包括静脉注射地塞米松,减轻眼组织炎症反应;口服泮托拉唑肠溶片,抑制产酸,保护胃;静脉注射血塞通,改善眼部供血,促进毒素代谢;维生素C,钴胺,和维生素B1用于神经营养和抗氧化作用;局部应用妥布霉素-地塞米松滴眼液用于抗炎目的;用盐水反复冲洗结膜囊。最后,病人好转并出院。
结果:积极治疗后,患者最终改善了复视和上睑下垂。
结论:该报告标志着吡虫啉引起的动眼神经麻痹的第一份文献,以复视为特征,和眼睑下垂,没有眼运动的实质性限制。治疗干预后,患者表现出明显的改善,并已出院,为今后临床实践中类似病例的治疗提供参考。它也提醒公众在使用吡虫啉时采取适当的预防措施。
BACKGROUND: Amid the pervasive deployment of imidacloprid, the incidence of poisoning from this compound has risen markedly. Those afflicted with imidacloprid poisoning typically exhibit symptoms ranging from headaches, dizziness, nausea, and abdominal pain, to impaired consciousness and breathlessness, yet instances of ocular paralysis induced by this toxin have not previously been documented.
METHODS: When the pesticide spray inadvertently made contact with the patient\'s eyes, they were seared with a burning sensation and discomfort. Subsequent to this incident, on the second day, the individual began to experience diplopia in the right eye and found it arduous to elevate his eyelids, indicating a challenge in achieving full extension.
METHODS: Based on the medical history, symptoms, and signs, the patient was diagnosed with oculomotor nerve palsy caused by imidacloprid.
METHODS: The treatment involved intravenous dexamethasone to reduce inflammatory response in the eye tissue; oral pantoprazole enteric-coated tablets to suppress acid production and protect the stomach; Xuesaitong administered intravenously to improve blood supply to the eye and promote metabolism of toxins; vitamin C, cobamamide, and vitamin B1 for nerve nutrition and antioxidant effects; local application of tobramycin-dexamethasone eye drops for anti-inflammatory purposes; and repeated flushing of the conjunctival sac with saline. Finally, the patient improved and was discharged.
RESULTS: After active treatment, the patient finally improved diplopia and ptosis.
CONCLUSIONS: This report marks the first documentation of oculomotor nerve palsy induced by imidacloprid, featuring diplopia, and blepharoptosis without substantial limitation of ocular motility. Following therapeutic intervention, the patient showed marked improvement and was discharged from the hospital, providing a point of reference for the treatment of analogous cases in future clinical practice. It also serves as a reminder for the public to take appropriate precautions when using imidacloprid.