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Case ReportOpen Access
Neurological Manifestation of Methyl Bromide Intoxication
Suwanlaong K 
,
Phanthumchinda K
,
Phanthumchinda K Methyl bromide is a highly toxic gas with poor olfactory warning properties. It is widely used as
insecticidal fumigant for dry foodstuffs and can be toxic to central and peripheral nervous systems. Most
neurological manifestations of methyl bromide intoxication occur from inhalation. Acute toxicity characterized
by headache, dizziness, abdominal pain, nausea, vomiting and visual disturbances. Tremor, convulsion, unconsciousness
and permanent brain damage may occur in severe poisoning. Chronic exposure can cause
neuropathy, pyramidal and cerebellar dysfunction, as well as neuropsychiatric disturbances. The first case of
methyl bromide intoxication in Thailand has been described. The patient was a 24-year-old man who worked
in a warehouse of imported vegetables fumigated with methyl bromide. He presented with unstable gait,
vertigo and paresthesia of both feet, for two weeks. He had a history of chronic exposure to methyl bromide for
three years. His fourteen co-workers also developed the same symptoms but less in severity. Neurological
examination revealed ataxic gait, decreased pain and vibratory sense on both feet, impaired cerebellar signs
and hyperactive reflex in all extremities. The serum concentration of methyl bromide was 8.18 mg/dl.
Electrophysilogical study was normal. Magnetic resonance imaging of the brain (MRI) revealed bilateral
symmetrical lesion of abnormal hypersignal intensity on T2 and fluid-attenuation inversion recovery (FLAIR)
sequences at bilateral dentate nuclei of cerebellum and periventricular area of the fourth ventricle. This
incident stresses the need for improvement of worker education and safety precautions during all stages of
methyl bromide fumigation.
Keywords: Methyl bromide, Intoxication
insecticidal fumigant for dry foodstuffs and can be toxic to central and peripheral nervous systems. Most
neurological manifestations of methyl bromide intoxication occur from inhalation. Acute toxicity characterized
by headache, dizziness, abdominal pain, nausea, vomiting and visual disturbances. Tremor, convulsion, unconsciousness
and permanent brain damage may occur in severe poisoning. Chronic exposure can cause
neuropathy, pyramidal and cerebellar dysfunction, as well as neuropsychiatric disturbances. The first case of
methyl bromide intoxication in Thailand has been described. The patient was a 24-year-old man who worked
in a warehouse of imported vegetables fumigated with methyl bromide. He presented with unstable gait,
vertigo and paresthesia of both feet, for two weeks. He had a history of chronic exposure to methyl bromide for
three years. His fourteen co-workers also developed the same symptoms but less in severity. Neurological
examination revealed ataxic gait, decreased pain and vibratory sense on both feet, impaired cerebellar signs
and hyperactive reflex in all extremities. The serum concentration of methyl bromide was 8.18 mg/dl.
Electrophysilogical study was normal. Magnetic resonance imaging of the brain (MRI) revealed bilateral
symmetrical lesion of abnormal hypersignal intensity on T2 and fluid-attenuation inversion recovery (FLAIR)
sequences at bilateral dentate nuclei of cerebellum and periventricular area of the fourth ventricle. This
incident stresses the need for improvement of worker education and safety precautions during all stages of
methyl bromide fumigation.
Keywords: Methyl bromide, Intoxication
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