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

BMC Neurol. 2022 May 16;22(1):181. doi: 10.1186/s12883-022-02712-3.

Abstract

Background: 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.

Case presentation: 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.

Conclusion: Bromism can cause acute encephalopathy, and it is important to differentiate it from Wernicke-Korsakoff syndrome.

Keywords: Bromism; Bromisoval; Bromovalerylurea; Korsakoff’s syndrome; Status epilepticus; Wernicke’s encephalopathy.

Publication types

  • Case Reports

MeSH terms

  • Bromisovalum*
  • Humans
  • Korsakoff Syndrome* / complications
  • Memory Disorders / etiology
  • Status Epilepticus* / complications
  • Status Epilepticus* / diagnosis
  • Wernicke Encephalopathy* / diagnosis
  • Wernicke Encephalopathy* / etiology
  • Wernicke Encephalopathy* / pathology

Substances

  • Bromisovalum