Bismuth encephalopathy has been most commonly reported in patients taking high-dose bismuth preparations for gastrointestinal disease. Encephalopathy has also been found to follow the use of bismuth iodoform paraffin paste (BIPP), a preparation used for chronic packing of wound cavities after surgery to the head and neck (1).
Usual symptoms:
Bismuth is thought to interfere with oxidative metabolism in the brain by binding the thiol groups of essential enzymes, and by reducing cerebral blood flow.
Encephalopathy has not been associated with the low dose bismuth preparations currently used to treat Helicobacter pylori infections.
Reference:
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