Central anticholinergic syndrome: a case report.
Postoperative central anticholinergic syndrome (CAS) is caused by anticholinergic medications that cross the blood-brain barrier. Medications with central anticholinergic effects block muscarinic cholinergic receptors, resulting in a wide array of symptoms. Symptoms may range from coma to a highly agitated state. CAS may be underdiagnosed because of its varying presentation and lack of awareness. Differential diagnosis for the patient presenting with abnormal neurological signs and symptoms should include CAS after the exclusion of other potential causes. This case report details the occurrence of CAS in a patient in her 20's. A review of CAS including causes, signs and symptoms, incidence, differential diagnosis, and treatment is discussed.
Moos
Daniel D
DD
Kearney Anesthesia Associates PC, Kearney, NE, USA. moosd@charter.net
D000328:Adult; D017109:Akathisia, Drug-Induced / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D000556:Ambulatory Surgical Procedures; D001812:Blood-Brain Barrier; D015984:Causality; D017081:Cholecystectomy, Laparoscopic; D018680:Cholinergic Antagonists / Q000009:adverse effects* / Q000493:pharmacokinetics; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005158:Facial Paralysis / Q000139:chemically induced; D005260:Female; D006801:Humans; D015994:Incidence; D009207:Myoclonus / Q000139:chemically induced; D009730:Nursing Assessment; D009759:Nystagmus, Pathologic / Q000139:chemically induced; D010830:Physostigmine / Q000627:therapeutic use; D016528:Postanesthesia Nursing; D011976:Receptors, Muscarinic / Q000187:drug effects; D012120:Respiration Disorders / Q000139:chemically induced; D013577:Syndrome
D018680:Cholinergic Antagonists; D002800:Cholinesterase Inhibitors; D011976:Receptors, Muscarinic; D010830:Physostigmine