Opsoclonus Due to Diphenhydramine Poisoning  

Oleh:

Carstairs, Shaun D. ; SchneirA, aron B.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 363 no. 27 (Dec. 2010), page 363:e40.
Topik: Diphenhydramine; Eye Desease

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2010.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

A 20-year-old woman was evaluated at the hospital 2 hours after ingesting 5 g of diphenhydramine in a suicide attempt. She had a generalized seizure en route to the hospital and several more in the emergency department. Electrocardiography revealed sinus tachycardia (172 beats per minute) with a QRS duration of 172 msec. Physical examination was remarkable for rapid horizontal, vertical, and rotatory conjugate movements of the eyes, diagnosed as opsoclonus (see video at NEJM.org). Opsoclonus consists of involuntary, irregular, back-to-back, multivectorial, saccadic eye movements while the gaze is fixed. Seen primarily in association with autoimmune processes after viral infection and paraneoplastic encephalitis, opsoclonus has also been described after ingestion of organophosphates, lithium, cetirizine, amitriptyline, diphenhydramine, or other substances. The patient underwent endotracheal intubation for airway protection and was treated with sodium bicarbonate, with resultant reduction of the QRS interval to 88 msec. No further seizures occurred; the opsoclonus was resolved by 8 hours after her arrival. The patient was extubated the following day and was later transferred to a psychiatric facility.

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