1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-6-82-b 10.15844/pedneurbriefs-6-11-3 Toxic Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Tremorogenic Toxic Encephalopathy http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 11 1992 01 07 2016 6 11 82 82 Copyright: © 1992 The Author(s) 1992 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Aflatoxin and encephalopathy with fatty degeneration of viscera (Reye)

A 16 year old boy who developed tremorogenic toxic encephalopathy as a result of inhalation and/or ingestion of mouldy silage containing aspergillus fumigatus, flavus and clavitus is reported from Halifax, Nova Scotia and Kingston, Ontario, Canada.

 Tremorogenic Toxic Encephalopathy Aspergillus Flavus Aflatoxins

A 16 year old boy who developed tremorogenic toxic encephalopathy as a result of inhalation and/or ingestion of mouldy silage containing aspergillus fumigatus, flavus and clavitus is reported from Halifax, Nova Scotia and Kingston, Ontario, Canada. Malaise, fatigue and headache were followed by fever, chills and vomiting. On recovery from these symptoms the boy had progressive dullness of mentation, an incapacitating tremor and rigidity. He was disorientated, his fund of knowledge was reduced and he could not add 2 digit numbers. The trembling and encephalopathy resolved after 7 days and his recovery has appeared to be complete. [1]

COMMENT. Reye’s syndrome has been attributed to the ingestion of aflatoxins, a form of naturally occurring mycotoxin found on corn [2]. Other foods sometimes contaminated by the aspergillus flavus and aflatoxins include peanuts, rice, cereals, soybeans and peas. Corn produced in southeastern United States has contained more than 20-100 ppb aflatoxin in 30% of samples tested. The tremorogenic mycotoxins induce rye grass staggers and bermuda grass tremors in sheep and cattle, but more commonly the aflatoxins are known for their effects on the liver and kidneys of animals and humans.

 Gordon K Masotti R Waddell W Tremorogenic toxic encephalopathy: a role of mycotoxins in the production of CNS disease in humans? Ann Neurol 1992 Sept 32 453 (abstr) Dvorackova I Kusak V Vesely D Vesela J Nesnidal P Aflatoxin and encephalopathy with fatty degeneration of viscera (Reye) Ann Nutr Aliment 1977 31 4-6 977 989 613946