Case of the Month
Impaired energy-dependent processes underlie acute lead neuropathy
Version of Record online: 26 NOV 2012
Copyright © 2012 Wiley Periodicals, Inc.
Muscle & Nerve
Volume 46, Issue 6, pages 954–956, December 2012
How to Cite
Krishnan, A. V., Park, S. B., Huynh, W., Lin, C. S.-Y., Henderson, R. D. and Kiernan, M. C. (2012), Impaired energy-dependent processes underlie acute lead neuropathy. Muscle Nerve, 46: 954–956. doi: 10.1002/mus.23425
- Issue online: 26 NOV 2012
- Version of Record online: 26 NOV 2012
- Accepted manuscript online: 24 APR 2012 05:49AM EST
- Manuscript Accepted: 19 APR 2012
- nerve excitability;
- sodium pump
The mechanisms of lead neuropathy remain unexplained. A 48-year-old painter presented after undertaking a 3-week project of paint removal without the use of a protective mask. Two weeks later, he developed fasciculations, weakness, and muscle wasting. Nerve conduction studies demonstrated a motor neuropathy. A high serum lead level was identified, leading to a diagnosis of acute lead neuropathy.
To investigate the pathophysiology, nerve excitability studies were undertaken acutely and in convalescence. Studies were undertaken at baseline and after the induction of limb ischemia.
Prominent abnormalities of excitability were noted, including a rightward shift of stimulus–response curves, reduction in depolarizing threshold electrotonus, and increased refractoriness. These changes became more severe with limb ischemia, and there was abolition of the superexcitable period and increased refractoriness.
We identified prominent changes in nerve excitability in lead neuropathy. The results suggest that there is impairment of axonal energy-dependent processes in lead neuropathy. Muscle Nerve, 2012