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Central anticholinergic syndrome

D D Batouche, N-F Benatta, K Tabeliouna, S Boudjahfa, Y Touhami, S Hakkoum
OBJECTIVE: To identify a hypertensive clinical form of atropine or anticholinergic toxidrome secondary to accidental consumption of Datura seeds. PATIENTS AND METHODS: We report two cases of Datura intoxication in two children who presented marked anticholinergic syndrome whose diagnosis was made by the anamnesis and the clinic. RESULT: Patient 1: A 5-year-old boy, returns home agitated with balance disorders. He was admitted to pediatric resuscitation unit...
May 11, 2018: Annales de Cardiologie et D'angéiologie
Hojae Cho, Jiyeon Kim
A 37-year-old female patient, 57 kg and 160 cm, underwent laparoscopic appendectomy. In the recovery room, fentanyl 100 mcg was intravenously administered for pain control. Three minutes after the administration, the patient developed intense and uncontrolled myoclonus, lower limb rigidity, agitation, aphasia, and periocular and neck swelling. The myoclonus and rigidity were suspected to be due to the opioid administration, and thus, naloxone was administered, but the symptoms were not improved. The patient's symptoms continued until the patient received administration of physostigmine...
April 2018: Saudi Journal of Anaesthesia
John Heesakkers, Montserrat Espuña Pons, Philip Toozs Hobson, Emmanuel Chartier-Kastler
Overactive bladder (OAB) syndrome is a common, complex, and challenging condition. To assist the management of these patients, the European Association of Urology (EAU) updates its guidelines annually. This review reports the presentations from the symposium titled "Dealing with complex OAB patient profiles: in or out of the EAU guidelines?" held at the 32nd EAU Annual Congress in March 2017 in London. The symposium focused on three groups of OAB patients: women who may also suffer pelvic organ prolapse, stress urinary incontinence, the genitourinary syndrome of menopause (GSM); patients at risk of cognitive impairment; and elderly patients...
2017: Research and Reports in Urology
Takeshi Nishimura, Hayato Maruguchi, Atsunori Nakao, Shinichi Nakayama
Althoughtricyclic antidepressants(TCAs) are frequently prescribed to patients with depression, these drugs can also be misused. A 21-year-old comatose patient was referred to our hospital presenting with ventricular tachycardia. Despite initial treatment including intravascular lipid emulsion, ventricular fibrillation occurred soon after arrival. Venoarterial extracorporeal membrane oxygenation and therapeutic hypothermia were administered. Refractory arrhythmia disappeared on the next day. A high concentration of amitriptyline was identified in his blood samples on arrival...
October 10, 2017: BMJ Case Reports
Guntram Lock, Alexander Reinhardt, Klaus Waldmann, Uta Menne
No abstract text is available yet for this article.
August 2017: American Journal of Gastroenterology
Xiao Chi Zhang, Natalija Farrell, Thomas Haronian, Jason Hack
BACKGROUND: Scopolamine is a potent anticholinergic compound used commonly for the prevention of postoperative nausea and vomiting. Scopolamine can cause atypical anticholinergic syndromes due to its prominent central antimuscarinic effects. CASE REPORT: A 47-year-old female presented to the emergency department (ED) 20 h after hospital discharge for a right-knee meniscectomy, with altered mental status (AMS) and dystonic extremity movements that began 12 h after her procedure...
October 2017: Journal of Emergency Medicine
Celia Y Quang, Scott G Blair, Robert Watson, Sidney B Brevard, Jon D Simmons, Marcus C B Tan
No abstract text is available yet for this article.
March 1, 2017: American Surgeon
Celia Y Quang, Scott G Blair, Robert Watson, Sidney B Brevard, Jon D Simmons, Marcus C B Tan
No abstract text is available yet for this article.
March 1, 2017: American Surgeon
S J Traub, M D Levine
Many substances can affect the central nervous system, and may cause patients to become critically ill. Acute central neurotoxicologic syndromes associated with drugs of abuse are usually caused by an overdose of sedative-hypnotic agents (including alcohol) or opioids, withdrawal from sedative-hypnotic agents, or an overdose of anticholinergic or sympathomimetic agents. Clinical findings are often syndromic, making physical examination the most important diagnostic tool in the approach to the patient with an unknown ingestion...
2017: Handbook of Clinical Neurology
Ullhas Sudhakarrao Misal, Suchita Annasaheb Joshi, Mudassir Mohd Shaikh
Delayed awakening from anesthesia remains one of the biggest challenges that involve an anesthesiologist. With the general use of fast-acting anesthetic agents, patients usually awaken quickly in the postoperative period. The time to emerge from anesthesia is affected by patient factors, anesthetic factors, duration of surgery, and painful stimulation. The principal factors responsible for delayed awakening following anesthesia are anesthetic agents and medications used in the perioperative period. Nonpharmacological causes may have a serious sequel, hence recognizing these organic conditions is important...
May 2016: Anesthesia, Essays and Researches
Lesley A Houghton, Margaret Heitkemper, Michael Crowell, Anton Emmanuel, Albena Halpert, James A McRoberts, Brenda Toner
Patients with functional gastrointestinal disorders (FGIDs) often experience distress, reduced quality of life, a perceived lack of validation, and an unsatisfactory experience with health care providers. A health care provider can provide the patient with a framework in which to understand and legitimize their symptoms, remove self-doubt or blame, and identify factors that contribute to symptoms that the patient can influence or control. This framework is implemented with the consideration of important factors that impact FGIDs, such as gender, age, society, and the patient's perspective...
February 15, 2016: Gastroenterology
M S Danilov, K M Lebedinskii
While reading special literature in diferent languages the authors noted surprising fact: the term and concept of "central anticholinergic syndrome" is well-known as common anaesthesia complication in German (abbr: ZAS) and partially Spanish sources, but in Russian, English or French literature is used only in toxicological context. Describing etiology, pathogenesis, symptoms, diagnosis and treatment of the complication manifesting with comatose, agitated or shivering forms, the authors analyzing the reasons for such a noticeably diferent approaches to the situation reaching 10% of all the general anaesthesia cases...
November 2015: Anesteziologiia i Reanimatologiia
Linea Natalie Toksvang, Ronni R Plovsing
Anesthesia-related central anticholinergic syndrome (CAS) is most commonly associated with administration of atropine or scopolamine, whereas glycopyrrolate is an extremely rare cause of CAS. Here, we report a case of CAS in a 5-year-old boy admitted to the intensive care unit. Immediately after the administration of glycopyrrolate, he became agitated and developed apnea, hypertension, tachycardia, and anuria. Although the present case describes a rare cause of CAS, it is an important reminder of an iatrogenic condition that is presumably underdiagnosed in the operating theater as well as the intensive care unit...
January 15, 2016: A & A Case Reports
X Cao, Y Cui, P F White, J Tang, H Ma
A 58-year-old male was scheduled to undergo radical gastrectomy for cancer under general anesthesia. The patient developed agitation and irregular breathing after receiving a single dose of atropine (0.5 mg) to treat bradycardia immediately prior to induction of anesthesia. Within 5 min after the atropine injection, the patient became unresponsive with facial flushing and diaphoresis. When a drop in oxygen saturation was observed, a laryngeal mask airway was inserted after administering a small bolus dose of propofol (80 mg) and the patient was ventilated with 100% oxygen...
February 2016: Acta Anaesthesiologica Scandinavica
N C Roche, L Raynaud, F Bompaire, J-J Lucas, Y Auxéméry
INTRODUCTION: Electroconvulsive therapy (ECT) is most frequently indicated for episodes of melancholic depression, but is also useful in the treatment of maniac syndrome and some schizophrenia subtypes. ECT is part of the treatment of movement disorders, neuroleptic malignant syndrome and even in the treatment of severe conversions. Although the therapeutic results are excellent when used appropriately, the mortality rate is estimated between 2 and 4 for 100,000 shocks. Despite this mortality rate, the benefit-risk ratio remains very positive and serious complications are extremely rare...
February 2016: L'Encéphale
S Suresh Kumar, Nikhil Jain, Smita Prakash, Mridula Pawar
No abstract text is available yet for this article.
May 2015: Indian Journal of Anaesthesia
Erdinç Ceylan, Muhammet Derda Ozer, Yusuf Cem Yilmaz, Baki Kartal, Dilbade Yildiz Ekinci, Emine Çinici, Nihan Aksu Ceylan
PURPOSE: The purpose of this study is to investigate the effects of long-term clozapine usage on tear film stability and corneal topographic parameters. MATERIAL AND METHODS: The study was conducted between March 2014 and November 2014. Thirty patients who were diagnosed of schizophrenia and have been under clozapine treatment for 2.73 ± 0.73 years (range 2-4 years) were involved in this study (group 1). Thirty healthy subjects (group 2) who have statistically similar demographic features compared with the group 1, were involved as a control group...
March 2016: Cutaneous and Ocular Toxicology
Chunjie Li, Fanglong Wu, Qi Zhang, Qinghong Gao, Zongdao Shi, Longjiang Li
BACKGROUND: Frey's syndrome is a rare disorder, the symptoms of which include sweating, flushing and warming over the preauricular and temporal areas following a gustatory stimulus. It often occurs in patients who have undergone parotidectomy, submandibular gland surgery, radical neck dissection, infection and traumatic injury in the parotid region, and is caused by the aberrant regrowth of facial autonomic nerve fibres. Currently there are several options used to treat patients with Frey's syndrome; for example, the topical application of anticholinergics and antiperspirants, and the intradermal injection of botulinum toxin...
March 17, 2015: Cochrane Database of Systematic Reviews
Mohamad Gharavifard, Majid Razavi, Mehdi Ghandehari Motlagh, Mohsen Ziyaeifard
Central anticholinergic syndrome (CAS) following general anesthesia (GA) is a well known syndrome in children and adults. Many cases of CAS have been previously reported in the literature. However, there are only two reports of post resuscitation CAS after administration of small doses of atropine. Hereby, we report a case of CAS in a child undergoing complete dental restoration under GA after receiving a small dose of atropine to reverse hypoxia induced bradycardia. Intraoperative events such as hypoxia or cardiac arrest may play a role as triggers for CAS...
September 2014: Journal of Dentistry of Tehran University of Medical Sciences
Giovanni Fratto, Licia Manzon
Patients with problems related to central nervous system dysfunctions are often treated with psychotropic drugs. These include antipsychotics, antidepressants, mood stabilizers, anticonvulsants, and drugs blocking specific receptors in the brain such as anticholinergics or beta-blockers. However, these medications have serious side effects affecting the oral health. In addition, many dental patients make use of psychoactive drugs, such as amphetamine, ecstasy, and cocaine. This article aims to review data on the psychotropic drugs being used in the last 30 years, their pharmacological profile, with special attention to the side effects related to the oral health...
2014: International Journal of Psychiatry in Medicine
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