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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.35 no.2 São Paulo June 1977

http://dx.doi.org/10.1590/S0004-282X1977000200005 

Comprometimento neurológico por inseticidas: estudo das manifestações crônicas em 13 casos

 

Neurological manifestations induced by insecticides: a study of 13 patients with chronic manifestations

 

 

Edison Matos NóvakI; Lineu Cesar WerneckII

IResidente de Neurologia. Departamento de Clínica Médica da Universidade Federal do Paraná e Setor de Toxicologia do Instituto Médico-Legal da Secretaria de Segurança Pública do Estado do Paraná, Curitiba
IIAuxiliar de Ensino de Neurologia. Departamento de Clínica Médica da Universidade Federal do Paraná e Setor de Toxicologia do Instituto Médico-Legal da Secretaria de Segurança Pública do Estado do Paraná, Curitiba

 

 


RESUMO

Foram estudados 13 pacientes com manifestações neurológicas crônicas deter minadas por inseticidas organoclorados e organofosforados. Todos apresentavam pelo menos quatro de cinco condições adotadas para o diagnóstico. A sintomatologia compreendeu neuropatias motoras puras e mistas, mielopatias e lesão de nervos cranianos. A pesquisa de inseticidas no sangue e urina foi positiva em todos os pacientes em que foi realizada. Estudo eletromiográfico em oito casos mostrou padrão neuropático em sete deles. A medida da velocidade de condução nervosa motora mostrou redução em todos os casos em pelo menos um nervo estudado. A conduta foi espectante, sendo que todos os pacientes tiveram remissão total ou parcial do quadro clínico, em prazos variáveis após o afastamento da zona rural. São abordados aspectos da patogenia e feita revisão da literatura. Os autores concluem sobre a importância relativa da pesquisa de inseticidas no sangue e urina e especulam sobre a existência de outros fatores coadjuvantes na etio-patogenia da doença desencadeada pelos defensivos agrícolas.


SUMMARY

The clinical study of 13 patients with chronic neurological manifestation induced by insecticides (organophosphorades and organochlorades compounds) is reported. Twelve patients were male and farmers and one was a saleslady. The authors adopted five conditions for diagnosis: frequent contact with insecticides, synptomatology directly related to the compounds exposition, clinical and laboratorial exclusion of others pathologies, quickly improvement of the symptons when the patients were away from their original environment and higt levels of insecticides in blood and urine determination. The clinical data was not uniform and the manifestation include pure motor neuropathy, mixed sensory-motor neuropathy, mielopathy and cranial nerves palsies. No relationship could be estabilished between the insecticides (type, frequency of number of exposition) to the clinical picture. The insecticides determination was positive (moderated or elevated levels) in all patients and in 40% of controls (traces). Eletromyographic studies showed a neuropathic pattern in the majority of cases and reduced motor nerve conduction velocities.
The authors believe that insecticides determination has a relative value and others criterion must be used in the diagnosis of chronic illness caused by insecticides. They think that others factors can be related with the symptomatology (hypersensibility, malnutrition, previous sensibilization or cumulative effect).


 

 

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Trabalho realizado na Disciplina de Neurologia do Departamento de Clínica Médica da Universidade Federal do Paraná e Setor de Toxicologia do Instituto Médico-Legal da Secretaria de Segurança Pública do Estado do Paraná, Curitiba.
Agradecemos aos Drs. Dilermando Brito Filho, José Antônio Mansano Campanholi. Judimar de Moraes Jung, Lenia Monteiro Moraes e Solange Nely Volpato Kyt, todos do Setor de Toxicologia do Instituto Médico-Legal da Secretaria de Segurança Pública do Paraná, que gentilmente realizaram a pesquisa de inseticidas.

Disciplina de Neurologia, Departamento de Clinica Médica - Hospital de Clínicas, - Rua General Carneiro s/nº - 80.000 Curitiba, PR - Brasil.

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