| Multiple System Atrophy Following Chronic Carbon Disulfide Exposure Howard Frumkin Department of Environmental and Occupational Health, Rollins School of Public Health of Emory University, Atlanta, GA 30322 USA Abstract
Carbon disulfide toxicity is well characterized. The principal target organ is the nervous system, although cardiovascular, reproductive, ophthalmologic, and other effects are also recognized. The neurotoxicity manifests in three ways: encephalopathy, peripheral and cranial nerve dysfunction, and movement abnormalities. This report describes a case of olivopontocerebellar atrophy, a form of multiple system atrophy, developing in an adult after over 30 years of occupational exposure to carbon disulfide. The patient presented with the insidious onset of balance problems, impotence, and irritability, without tremor, cogwheel rigidity, bradykinesia, or changes in facial expression. Over the next few years severe ataxia developed, and the clinical diagnosis was confirmed with computed tomography and magnetic resonance imaging scans. The patient experienced multiple medical complications and died approximately 9 years after diagnosis. This case is consistent with a large body of clinical and experimental literature, much of it 50 years old, showing that carbon disulfide can cause movement disorders. It also serves as a reminder that movement disorders, ranging from parkinsonism to dystonia, are associated with a variety of toxic exposures such as manganese, carbon monoxide, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, and medications. Key words: carbon disulfide, cellulose, environmental diseases, movement disorders, multiple system atrophy, occupational diseases, olivopontocerebellar atrophy, rayon, textiles. Environ Health Perspect 106:611-613 (1998) . [Online 18 August 1998]. http://ehpnet1.niehs.nih.gov/docs/1998/106p611-613frumkin/ abstract.html Address correspondence to H. Frumkin, Department of Environmental and Occupational Health, Rollins School of Public Health of Emory University, 1518 Clifton Road, Atlanta, GA 30322 USA. This work was supported in part by NIEHS Environmental/Occupational Medicine Academic Award 5 KO7 ESO0257. Received 30 July 1998 ; accepted 3 August 1998.
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