[Characteristics of clinical, Magnetic Resonance Imaging and electroencephalogram after trimethyltin chloride poisoning].

Objective: Characteristics of clinical, MRI and electroencephalogram after trimethyltin chloride (TMT) poisoning. Methods: The clinical manifestations, MRI, EEG, treatment and prognosis of 16 patients with TMT poisoning were analyzed retrospectively. Results: Among the 16 cases of TMT poisoning, 6 cases were severe poisoning, 4 cases were moderate poisoning, and 6 cases were mild poisoning. All patients had dizziness, headache, general fatigue, loss of appetite, nausea, vomiting and other general clinical symptoms. Six patients with severe poisoning had psychobehavioral abnormalities, including 4 patients with mania, delirium, ataxia, epileptic seizures. Glasgow was 15 points in mild and moderate poisoning. Of the 6 cases of severe poisoning, 4 cases of Glasgow were 9~11 points, and 2 cases of Glasgow were 13 points. 2 patients with severe poisoning had abnormal MRI in head, and the total abnormal rate was 12.50%. Toxic encephalopathy was considered in 1 case with abnormal signal of corpus callosum pressure, and patchy ischemic foci of left cerebral foot and mild cerebral atrophy in 1 case. The total abnormal rate of EEG was 56.25%. The abnormal rate of electroencephalogram in severe poisoning was 83.33%. There were 2 cases of severe abnormal electroencephalogram, 2 cases of moderate abnormal electroencephalogram and 1 case of slight abnormal electroencephalogram. Twelve patients were recovered and discharged from hospital. 4 cases of severe poisoning are still getting better, and there are still cerebellar ataxia symptoms such as dizziness and unstable walking. Conclusion: In clinical work, attention should be paid to the identification of patients with mild and moderate TMT poisoning, and attention should be paid to the patients with severe TMT poisoning manifested by disturbance of consciousness. The positive rate of MRI test in TMT poisoning is low, and the lesion is nonspecific. Electroencephalogram test has a high positive rate in TMT poisoning, which can well reflect the degree of illness. Attention should be paid to the prevention and treatment of neurodegeneration caused by TMT poisoning.目的： 探讨三甲基氯化锡（trimethyltin chloride，TMT）中毒后临床、MRI、脑电图的特点。 方法： 回顾性分析2016年8月12日至8月27日收治的16例TMT中毒患者的临床表现、MRI、脑电图、治疗措施及预后等资料。 结果： 16例TMT中毒患者中，6例为轻度TMT中毒，4例为中度TMT中毒，6例为重度TMT中毒。所有患者均出现头痛、头晕、食欲下降、恶心、呕吐、全身乏力等一般临床症状。6例重度中毒患者均出现精神行为异常，其中4例患者出现躁狂、谵妄、共济失调、癫痫发作。轻、中度中毒的患者Glasgow均为15分；6例重度中毒患者中，4例Glasgow为9~11分，2例Glasgow为13分。2例重度中毒患者头颅MRI出现异常，总异常率为12.50%；1例胼胝体压部异常信号考虑中毒性脑病，1例左侧大脑脚斑片状缺血灶及轻度脑萎缩。脑电图总异常率为56.25%；重度中毒脑电图异常率83.33%，2例重度异常脑电图，2例中度异常脑电图，1例轻度异常脑电图。12例患者痊愈出院，4例重度中毒患者好转后仍然有头晕、走路不稳等小脑性共济失调症状。 结论： 在临床工作中对于轻、中度TMT中毒患者取注意鉴别，高度重视以意识障碍为表现的重度中毒患者；MRI在TMT中毒检查中阳性率低，病灶无特异性；脑电图在TMT中毒检查中阳性率较高，能很好地反映病情程度；应重视防治TMT中毒所致的神经变性。.