Bromisoval-induced bromism with status epilepticus mimicking Wernicke's encephalopathy: report of two cases.

Masahiro Biyajima, Shunichi Satoh, Takahiro Morikawa, Yuki Morita, Rie Watanabe, Daisuke Matsui, Masataka Konno, Nobutoshi Morimoto, Yuichi Yatsu, Akihito Hirasaki, Hiroyuki Yahikozawa

BMC neurology 2022 May 16

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Bromine compounds are used in several drugs, including over-the-counter drugs. They sometimes cause intoxication known as bromism. Although the acute neurological symptoms and sequelae of bromism vary, few reports have mentioned acute encephalopathy. We report two cases of bromisoval-induced bromism with status epilepticus. Presence of pseudohyperchloremia and history of over-the-counter medication use guided the diagnosis. In the acute phase, our patients showed bilateral medial thalamic lesions on magnetic resonance imaging. The imaging findings were similar to those of Wernicke's encephalopathy. Although these findings improved in the chronic phase, neuropsychiatric sequelae, such as confabulation and amnesia, occurred. Bromism can cause acute encephalopathy, and it is important to differentiate it from Wernicke-Korsakoff syndrome. © 2022. The Author(s).

Citation

Masahiro Biyajima, Shunichi Satoh, Takahiro Morikawa, Yuki Morita, Rie Watanabe, Daisuke Matsui, Masataka Konno, Nobutoshi Morimoto, Yuichi Yatsu, Akihito Hirasaki, Hiroyuki Yahikozawa. Bromisoval-induced bromism with status epilepticus mimicking Wernicke's encephalopathy: report of two cases. BMC neurology. 2022 May 16;22(1):181