title: [Vigilance disorders in intensive care patients. The central anticholinergic syndrome as a differential diagnosis of a brain stem lesion].
abstract: Four days after implantation of a biventricular assist device (Berlin heart) the 39-year-old patient showed a sudden loss of vigilance and tetraplegia. Clinical skills and neurophysiological states indicated a serious lesion of the brain stem. After a test application of Physostigmine 2 days later, the neurological deficits improved dramatically. The case demonstrates that neurological deficits can also be caused by or combined with an acute anticholinergic syndrome. The application of Physostigmine allows disorders caused by brain lesions to be differentiated from transitory syndromes.
authors.affiliation: Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Georg-August-Universität, Göttingen.
authors.forename: J
authors.initials: J
authors.lastname: Rathgeber
authors.forename: B
authors.initials: B
authors.lastname: Kukowski
authors.forename: D
authors.initials: D
authors.lastname: Zenker
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology*; D001927:Brain Diseases / Q000175:diagnosis*; D001933:Brain Stem; D003937:Diagnosis, Differential; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D010830:Physostigmine; D011183:Postoperative Complications; D011782:Quadriplegia / Q000209:etiology*
chemical_list: D010830:Physostigmine
vernacular_title: Störungen der Vigilanz bei Intensivpatienten. Zentralanticholinerges Syndrom als Differentialdiagnose der Hirnstammläsion.