Central anticholinergic syndrome from orphenadrine in a 3 year old.
Orphenadrine (N,N-dimethyl-2(o-methyl-alpha-phenylbenzyloxy)ethylamine) is an analog of diphenhydramine with central and peripheral anticholinergic properties. It is commonly prescribed both as a muscle relaxant and as an adjunct to antipsychotic medications to prevent parkinsonism. We report a case of orphenadrine poisoning in a 3-year-old boy following ingestion of no more than two 100-mg tablets. Central anticholinergic toxicity was prominent, manifested by hallucinations and severe agitation. Orphenadrine can cause profound toxicity in children after ingestion of small doses, and should be considered as a potential cause for acute delirium in childhood.
Garza
M B
MB
University of Pennsylvania School of Medicine, Philadelphia, USA.
Osterhoudt
K C
KC
Rutstein
R
R
D002675:Child, Preschool; D018680:Cholinergic Antagonists / Q000506:poisoning*; D003693:Delirium / Q000139:chemically induced*; D004630:Emergencies; D006212:Hallucinations / Q000139:chemically induced*; D006801:Humans; D008297:Male; D009125:Muscle Relaxants, Central / Q000506:poisoning*; D009966:Orphenadrine / Q000506:poisoning*; D013577:Syndrome
D018680:Cholinergic Antagonists; D009125:Muscle Relaxants, Central; D009966:Orphenadrine