1/5. Intentional topiramate ingestion in an adolescent female.OBJECTIVE: To describe an intentional topiramate ingestion by an adolescent and warn of the potential for topiramate abuse. CASE SUMMARY: A 17-year-old female intentionally ingested approximately eight 100-mg topiramate tablets for the purpose of "getting high." Soon after ingestion, she was found at school obtunded and nonresponsive. Upon transfer to the emergency department, she became combative and aggressive with evolving neurologic abnormalities including incoherence, confusion, disorientation, and significant speech impairments including echolalia. Approximately 24 hours after ingestion, the patient had completely recovered without requiring specific treatment or experiencing sequelae. DISCUSSION: The clinical effects following acute topiramate intoxication appear consistent with the drug's known pharmacologic properties. There are few other reports of topiramate ingestions and most cases have had mild outcomes. CONCLUSIONS: Due to the multifactorial effects topiramate may have upon the central nervous system and its anorectic effect, abuse of this drug by adolescents should be considered upon presentation of an adolescent with mental status changes.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/5. Colonic irrigation-induced hyponatremia.A 42-year-old Chinese woman presented with transient confusional state and memory loss due to acute water intoxicational hyponatremia complicating colonic irrigation (enemas) used as an alternative medicine to promote health. Although there is no evidence that such "antiautointoxication" technique conveys true benefit in any condition, this form of "quackery" may actually cause harm, such as water intoxication as in this case.- - - - - - - - - - ranking = 3keywords = intoxication (Clic here for more details about this article) |
3/5. Refractory hypoglycemia secondary to topical salicylate intoxication.We describe a case of severe refractory hypoglycemia secondary to topical salicylate intoxication. A 72-year-old man with psoriasis and end-stage renal disease was treated with a topical cream containing 10% salicylic acid. The patient presented with encephalopathy and subsequently developed hypoglycemia refractory to infusions of large amounts of glucose. A serum salicylate concentration was elevated at 3.2 mmol/L. Emergent hemodialysis was accompanied by rapid lowering of serum salicylate concentration and resolution of refractory hypoglycemia. Salicylate is well absorbed across normal and diseased skin. Salicylate markedly impairs gluconeogenesis and increases glucose utilization, resulting in hypoglycemia. To our knowledge, this is the first article on hypoglycemia due to the application of topical salicylate.- - - - - - - - - - ranking = 5keywords = intoxication (Clic here for more details about this article) |
4/5. Scopolamine intoxication as a model of transient global amnesia.In colombia (south america) during recent decades the administration of scopolamine, extracted from plants belonging to the datura or Brugmansia genus, has become an important neurologic and toxicologic phenomenon. These extracts have been popularly known as "Burundanga." Chemical characteristics and clinical features of scopolamine intoxication are described. Anterograde amnesia and submissive behavior found in patients intoxicated with scopolamine are analyzed. Burundanga intoxication is related to other toxic phenomena found in different countries and similitudes with transient global amnesia are emphasized.- - - - - - - - - - ranking = 6keywords = intoxication (Clic here for more details about this article) |
5/5. mitral valve prolapse: association with bizarre behavior, a confusional state, and aphasia.A 30-year-old man was admitted to the hospital with a history of sudden onset of bizarre behavior and difficulty in speaking that initially was attributed to drug intoxication. Examination disclosed a confused young man with receptive and expressive aphasia. A late systolic murmur was heard in the mitral area and echocardiography confirmed the presence of mitral valve prolapse. A computed tomographic scan of the head and cerebral angiography showed abnormalities consistent with an infarct of the left temporo-occipital region. Since no other predisposing factors were present, this patient's stroke was probably related to mitral valve prolapse.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |