[An outbreak of encephalopathy after eating autumn mushroom (Sugihiratake; Pleurocybella porrigens) in patients with renal failure: a clinical analysis of ten cases in Yamagata, Japan].

摘要: In September and October, 2004, an outbreak of encephalopathy unknown etiology occurred in certain areas Japan including Yamagata, Akita, Niigata prefectures. These patients had a history chronic renal failure, most them undergone hemodialysis, also eating Sugihiratake (Pleurocybella porrigens), autumn mushroom without known toxicity. Since clinical details this type remain unknown, we analyzed the clinical, radiological electroencephalographic (EEG) features ten cases Yamagata prefecture. The summary present study is as follows: 1. Ten seven underwent hemodialysis. 2. Each patient within 2-3 weeks onset neurological symptoms. 3. was subacute; initial symptoms were tremor, dysarthria, and/or weakness extremities, which lasted average 4.5 days (ranging from 2 to 11 days), followed by severe consciousness disturbance intractable seizures, resulting status epilepticus 5 patients. Myoclonus seen 4 Babinski reflex 4. Brain CT MRI examinations unremarkable early stages disease. Three eight after onset, however, conspicuous lesions appeared insula basal ganglia 6 On MRI, these brain hyperintense on T2-weighted FLAIR images, hypointense T1-weighted images. 5. EEG examination performed patients, all whom showed abnormal findings. Periodic synchronous discharge (PSD) spike wave complex one patient, non-specific slow waves 6. Prognosis different case case. died at 13, 14, 29 onset. Two still persistent month One parkinsonism recovering disturbance. Four recovered nearly completely around 3 failure not they did need undergo This suggests that degree key for prognosis encephalopathy. endemic disease newly recognized entity