succimer and Tremor

A 22-year-old woman was admitted to the emergency department with symptoms of chest discomfort after a suicide attempt by injecting intravenously the amount of mercury extracted from 3 thermometers mixed with alcohol. At presentation, the patient was well oriented with normal vital signs, but a few hours later she presented an abrupt deterioration of her mental status, with confusion, disorientation, tremor and finally stupor. She was transferred to the intensive care unit for monitoring and therapy. A nasogastric tube was immediately placed and the patient received treatment with a chelating agent dimercaptosuccinic acid (DMSA)/succimer 800 mg orally three times a day, a dosage decided on the basis of her body weight, plus phenytoin 125 mg intravenously three times a day. Two hours after treatment initiation, the patient reported a remarkable improvement of her symptoms. However, she experienced seizures during a 6-month period after her discharge.

Topics: Administration, Intravenous; Adult; Anticonvulsants; Chelating Agents; Confusion; Ethanol; Female; Humans; Mercury; Phenytoin; Stupor; Succimer; Suicide, Attempted; Treatment Outcome; Tremor