Tardily Accelerated Neurologic Deterioration in Two-Step Thallium Intoxication

This document reported a case of a 16-year-old who experienced two-step thallium intoxication, leading to progressive neurologic deterioration. The first ingestion resulted in gastrointestinal symptoms, alopecia, and delayed neurologic symptoms such as visual loss and leg weakness. The second ingestion caused rapid worsening of neurologic symptoms without gastrointestinal or cutaneous effects. The case highlighted the cumulative neurotoxicity of thallium, as the nervous system retains thallium longer than other organs. Despite some recovery over two years, the patient’s visual loss persisted. The source of poisoning was later identified when a murder suspect confessed to the adulteration.