acute lead encephalopathy


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acute lead encephalopathy

A syndrome seen mostly in children who have absorbed a large amount of lead. Initially there are clumsiness, vertigo, ataxia, headache, insomnia, restlessness, and irritability. As the syndrome progresses, vomiting, agitation, confusion, convulsions, and coma will occur. A sudden, marked increase in intracranial pressure accompanies these symptoms. Sequelae include permanent damage to the central nervous system, causing mental retardation, electroencephalogram abnormalities, cerebral palsy, and optic atrophy.

Treatment

Exposure to lead must be discontinued. Corticosteroids and intravenous mannitol (20% solution) will relieve increased intracranial pressure. Lead can be removed from the body by giving dimercaprol (BAL) and calcium disodium edetate in a carefully administered doses. Convulsions may be controlled with phenobarbital, hydantoin, or diazepam. Hydration should be maintained with intravenous administration of fluids; solutions containing sodium should be avoided. Oral fluids or food should not be given for at least 3 days.

See also: encephalopathy