M. F. Gordon, R. I. Abrams, D. B. Rubin, W. B. Barr and D. D. Correa, “Bismuth Subsalicylate Toxicity as a Cause of Prolonged Encephalopathy with Myoclonus,” Movement Disorders, Vol. 10, No. 2, 1995, pp. 220-222. doi:10.1002/mds.870100215

has been cited by the following article:

• TITLE: Bismuth Toxicity: A Rare Cause of Neurologic Dysfunction

  AUTHORS: Paul T. Reynolds, Kathleen C. Abalos, Jennifer Hopp, Mark E. Williams

  KEYWORDS: Bismuth Toxicity; Creutzfeld-Jakob

  JOURNAL NAME: International Journal of Clinical Medicine, Vol.3 No.1, January 5, 2012

  ABSTRACT: Bismuth subsalicylate (Pepto-Bismol?) and other bismuth-containing compounds have been used for many years to treat gastroenterological complaints. Although safe in the majority of patients, bismuth can cause a well-described toxic state marked by progressive neurological decline. Features of bismuth toxicity include confusion, postural instability, myoclonus, and problems with language. This presentation can masquerade as other causes of progressive neurologic dysfunction including Creutzfeld-Jakob Disease (CJD), Hashimoto’s Encephalopathy, and others. In this case study, we present a patient who was using bismuth salicylate in toxic quantities to help control diarrhea. On initial presentation, several diagnoses were entertained before bismuth levels were obtained. This case study highlights the fact that bismuth toxicity, while rare, should be considered in a patient with progressive neurological decline. Also, we hope this case reminds physicians of a severe consequence of a common, readily available medication.