Shifu Liang,1,* Xiurong Zhu,1,* Yanxue Zheng,1,* Hong Zhao,1,* Li Zhou,2 Youlin Wu1 

1Department of Neurology, Chongzhou People’s Hospital, Sichuan, People’s Republic of China; 2Department of Neurology, Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Youlin Wu, Department of Neurology, Chongzhou People’s Hospital, No. 318, Yongkang East Road, Chongqing Subdistrict, Chongzhou, Sichuan, 611200, People’s Republic of China, Tel +86-028-61042229, Email suriv007@126.com

Abstract: Fluoroacetamide, a commonly used convulsant rodenticide, can rapidly damage the nervous, digestive, and cardiovascular systems, potentially leading to fatal outcomes if ingested. This study reports the case of a 62-year-old Chinese woman who presented with symptoms of intoxication, including slurred speech, agitation, and seizure-like episodes, accompanied by gastrointestinal symptoms such as vomiting, skin bruising, and mild liver dysfunction. Toxin analysis revealed the presence of fluoroacetate in her blood and urine, and diffusion weighted imaging (DWI) imaging indicated white matter lesions, leading to the diagnosis of rare fluoroacetamide poisoning. This diagnosis facilitated the administration of treatments including vitamin K, hemodialysis, acetamide, and calcium gluconate. The patient subsequently regained consciousness, with improvements in laboratory results and gradual resolution of toxic-metabolic encephalopathy. This case highlights the importance of considering drug poisoning in patients with challenging neurological symptoms, particularly when there is a potential history of drug ingestion. Accurate diagnosis of such conditions is crucial, as timely and appropriate treatment can significantly improve clinical outcomes.

Keywords: fluoroacetamide, reversible toxic-metabolic encephalopathy, case report