Glufosinate herbicide intoxication causing unconsciousness, convulsion, and 6th cranial nerve palsy

Abstract

Although glufosinate ammonium herbicides are considered safe when used properly, ingestion of the undiluted form can cause grave outcomes. Recently, we treated a 34-yr-old man who ingested glufosinate ammonium herbicide. In the course of treatment, the patient developed apnea, mental deterioration, and sixth cranial nerve palsy; he has since been discharged with full recovery after intensive care. This case report describes the clinical features of glufosinate intoxication with a focus on sixth cranial nerve palsy. Our observation suggests that neurologic manifestations after ingestion of a "low-grade toxicity herbicide" are variable and more complex than that was previously considered.

Keywords: Abducens Nerve Disease; Glufosinate Ammonium; Neurologic Manifestations.

Fig. 1

Summary of the clinical course of the patient and treatment.

Fig. 2

Sequential measurement of Lancaster red-green test on 6th (A), 7th (B), and 11th (C) day. Note the incomitant uncrossed diplopia at 9 different positions of gaze and the increased deviation at the right and left gaze suggesting sixth cranial nerve palsy; improvement was observed during subsequent follow-up examinations.