Typical clinical signs and symptoms of bismuth intoxication  are illustrated in a cases of a 45-year-old woman. Initially psychasthenia appears followed by acute delirium with ataxia, myoclonic jerks and occasionally coma. If patients survive the acute phase they recover only gradually following discontinuation of bismuth medication. In cases of extreme intoxication, permanent memory deficits may occur. Etiology, pathogenesis, laboratory findings, differential diagnosis and therapy of this rare iatrogenic encephalopathy are discussed.
Bismuth Chelating Agents