title: [Graded classification of acute chloralose poisoning. 509 cases].
abstract: OBJECTIVE
  The annual incidence of chloralose poisoning has exceeded 3 cases per 100,000 inhabitants in Tunisia since 1997. The purpose of this study was to analyze clinical features of chloralose poisoning.
  
  
  METHODS
  We reviewed patients admitted to the intensive care unit during the last 5 years to search for chloralose poisoning. The identified cases were classed into 5 grades by clinical features: depth of coma, characteristics of the myoclonia, and cerebral trunk reflex response.
  
  
  RESULTS
  We identified 509 cases of chloralose poisoning over the last 5 years. Seventy-five patients (14.7%) were in grade 1: drowsiness alone. Four hundred ten patients (80.8%) were in grades 2 and 3: hypertonic coma and myoclonus. The clinical course was favorable after sedation, tracheal intubation and mechanical ventilation. Twenty-three patients (4.6%) were in grades 4 and 5: hypertonic coma (Glasgow coma score = 3). Three of them died.
  
  
  CONCLUSIONS
  The clinical features of chloralose poisoning depend on the ingested dose. Despite the gravity of the initial clinical presentation, prognosis is excellent if symptomatic treatment is given early, even in grade 5 cases which simulate brain death.
authors.affiliation: Service de Réanimation médicale et de Toxicologie clinique, Centre Antipoison, Tunis.
authors.forename: C
authors.initials: C
authors.lastname: Hamouda
authors.forename: M
authors.initials: M
authors.lastname: Amamou
authors.forename: S
authors.initials: S
authors.lastname: Jédidi
authors.forename: A
authors.initials: A
authors.lastname: Hédhili
authors.forename: N B
authors.initials: NB
authors.lastname: Salah
authors.forename: H
authors.initials: H
authors.lastname: Thabet
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002698:Chloralose / Q000506:poisoning*; D003128:Coma / Q000209:etiology; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000506:poisoning*; D007362:Intensive Care Units; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D009207:Myoclonus / Q000209:etiology; D011041:Poisoning / Q000145:classification; D011379:Prognosis; D012121:Respiration, Artificial; D012189:Retrospective Studies
chemical_list: D006993:Hypnotics and Sedatives; D002698:Chloralose