The Effects of Thallium Salts, with Particular Reference to the Nervous System Changes<subtitle>A REPORT OF THREE CASES</subtitle>

Abstract

Three cases of proven thallium poisoning are presented, all of whom showed peripheral neuropathy with differing grades of severity. Post-mortem examination was made of two who died. The more acutely affected case showed little evidence of neuronal degeneration in the sciatic nerve and spinal cord. The less acutely affected second case showed marked and extensive distal degeneration of nerve fibres in all nerves examined, and early degenerative changes in nerve fibres in oculomotor muscles. Chromatolysis of affected motor nerve cells was prominent, but no other neuronal changes were visible in the rest of the central nervous system. The distal ‘dying back’ type pattern in sensory and motor nerves was consistent with the clinical symptomatology in all three cases. Thallium was detected in the cremated remains of Case 1, in the post-mortem tissues of Case 2, and in the urine seven weeks after poisoning in Case 3. The effects of thallium on the nervous system are re-evaluated in the light of these anatomical findings, and the general effects of thallium poisoning are reviewed.