Quadriplegia Due to Lead-contaminated Opium

Purpose: Utilization of lead-contaminated opium may lead to severe motor neuron impairment and quadriplegia. Case report: Forty years oriented old male, opium addict, was admitted to the ICU, with headache, nausea and abdominal pain, and weakness in his lower and upper extremities without definitive diagnosis. The past medical and occupational history was negative. Laboratory investigation showed; anemia (Hb 7.7 g/dl), slightly elevated liver function tests, elevated total bilirubin, and ESR. Abdominal sonography and brain CT scan were normal. EMG and NCV results and neurologic examination were suggestive for Guillain-Barre. He underwent five sessions of plasmapheresis. Blood lead level was >200 μg/dl. He received dimercaprol (BAL) and calcium disodium edetate (CaEDTA) for two five days session. Upon discharge from ICU all laboratory tests were normal and blood lead level was reduced, but he was quadriplegic. From Department of Anesthesiology & Intensive Care, Imam Khomeini Hospital, Tehran Univ. of Medical Sciences, Tehran, Iran. * MD., MPH, Fellowship of Intensive Care Medicine. ** MD, Assistant Professor of Anesthesiology. *** MD, Assistant Professor of Anesthesiology. **** Professor of Pharmacotherapy in Intensive Care Medicine. Corresponding author: Mohammad Taghi Beigmohammadi MD, Fellowship of Intensive Care Medicine. Anesthesiology & intensive Care Dept., Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, post. Code: 1419733141, Iran, Tel: +989121759016. E-mail: [email protected].