Neurológia pre prax 1/2021

Development of quadriparesis after delirium: simple routine or diagnostic challenge?

Chronic lead poisoning is a rare form of secondary coproporphyria. Porphyrias belong to the group of rare metabolic diseases caused by a congenital enzymatic defect or an acquired disorder of heme synthesis. Lead has an inhibitory effect on enzymes involved in heme synthesis. All initial symptoms of chronic poisoning are non-specific and easily overlooked. Severe chronic poisoning may be accompanied by damage to the nervous system. We report a case of a patient with an atypical clinical pattern of delirium in alcohol overuse with neuropsychiatric and internal complications. The aim of the paper is to highlight the importance of detailed history and comprehensive evaluation of a patient with a wide range of symptoms, requiring a multidisciplinary approach.

Keywords: poisoning, heme, lead, polyneuropathy