Neuropediatrics 2006; 37 - MP21
DOI: 10.1055/s-2006-943618

NEUROLOGICAL FEATURES IN CHILDREN AND DIPHENYLARSINIC ACID PROBABLY DERIVED FROM CHEMICAL WARFARE AGENTS

N Iwasaki 1, S Miyamoto 1, K Ishii 1, T Takeda 1, T Ohto 1, A Matsui 1, K Shin 1, H Satoh 1, M Tsuchida 1, R Tanaka 1, H Kinugasa 1, A Ieshima 1, T Ogata 1, M Ishizaki 1, A Tamaoka 1
  • 1Department of Pediatrics, Ibaraki Prefecttural University of Health Science, Ami-Machi, Ibaraki, Japan

Objectives: Diphenylarsinic acid (DPAA), an artificial organoarsinic compounds, is a material of diphenylcyanoarsine or diphenylchloroarsine, to use as emetic type chemical warfare agents. We found DPAA intoxication by oral ingestion of ground water in Kamisu, Japan. We reported that the characteristics of this intoxication for adults were homogeneous including cerebellar-brainstem symptoms such as ataxic gait and scanning speech, myoclonus, tremor, and sleep disorder, and cerebral symptoms such as visual impairment and memory impairment (Ishii K, et al., 2004). Here we report clinical features of children with oral ingestion of well water contained with DPAA.

Methods: Twenty-one children (10 males, 11 females; range 2 years to 11 years) were lived in the house where the well water that contained DPAA was participated. All underwent the neurological examinations, cranial MRI, EEG, cerebral blood flow SPECT. Developmental quotient or intelligence quotient was measured using a standardized developmental test or the wechsler intelligence scale for children-III (WISC-III).

Results: Complaints of elderly children as well as the adults were the cerebellar symptoms such as gait disturbance, ataxic gait and scanning speech, myoclonus and tremors, insomnia and/or nightmares. On the other hand, the younger children had mental retardation, motor disturbance. Four of twenty-one children proved to have mental retardation and three were borderline cases. The developmental quotients of three children were 68, 42, and 46. The WISC-III showed mild retardation (IQ of 66) in another child. The level of developmental disturbances may related to the age and amounts exposed to DPAA. MRI revealed brain atrophy in one child. A hypo-perfusion of cerebral blood flow by SPECT was demonstrated in the cerebellum, temporo-occipital lobe and mesial temporal lobes.

Conclusion: No previous reports of DPAA intoxication resulting from oral ingestion by human are know. DPAA intoxication can result in a pathological change in the central nervous system. DPAA may be particularly toxic to the developing central nervous system.