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45例患者,由于便秘而服用不溶性铋盐(亚硝酸盐),每日5—20克。持续4周到30年。做脑电图当天的血铋浓度为150～1600微克/升(正常<20微克/升),尿中浓度为200～9600微克/升,脑脊液的浓度为10～100微克/升。临床表现:第一阶段为隐袭相,持续1周至数月,逐渐产生忧郁、焦虑、激惹、甚至迫害妄想,如果没有了解到铋盐摄入史,容易作出错误解释。进一步可有情感、记忆和注意力方面的异常,不能作有计划的活动,与额叶病变表现相似。15例诉头痛。脑病的第二阶段在24—48小时内突然发生。其中4种症状经常出现,具有相当的诊断价值:不同程度的精神错乱,伴有肌阵挛跳动的假性震颤,发
In 45 patients, taking insoluble bismuth salts (nitrites) due to constipation, 5-20 g daily. Lasts 4 weeks to 30 years. The concentration of blood bismuth on the day of electroencephalogram was 150 to 1600 μg / L (normal <20 μg / L), urinary concentration was 200 to 9600 μg / L and CSF concentration was 10 to 100 μg / L. Clinical manifestations: The first phase of the hidden phase, lasting 1 week to several months, and gradually produce depression, anxiety, irritation, and even persecution delusions, if you do not understand the history of bismuth salt intake, easy to make a wrong explanation. Further emotional, memory and attentional abnormalities can not be planned activities, and the performance of frontal lobe similar. 15 cases complained of headache. The second phase of encephalopathy occurs suddenly within 24-48 hours. Of which 4 kinds of symptoms often appear, with considerable diagnostic value: varying degrees of confusion, accompanied by myoclonus beating pseudo-tremor, hair