[Coma with bilateral mydriasis after use of transdermal scopolamine in ICU].
We report the case of an ICU patient with previous medical history of head trauma with hydrocephalus requiring ventricular derivation, presenting a coma (Glasgow Coma Score=8) with bilateral mydriasis after the use of transdermal scopolamine (1 mg) for profuse bronchial secretions. Neurological explorations (CT-scan and electroencephalogram) confirmed the absence of organic cause to the neurological deterioration. Neurological status rapidly and completely improved after removal of transdermal scopolamine suggesting a central anticholinergic syndrome.
Repéssé
X
X
Département d'anesthésie-réanimation chirurgicale, hôpital de Bicêtre, APHP, faculté de médecine, université Paris-Sud, 94275 Le Kremlin-Bicêtre, France.
Geeraerts
T
T
Pottecher
J
J
Vigué
B
B
Benhamou
D
D
Duranteau
J
J
D000279:Administration, Cutaneous; D018680:Cholinergic Antagonists / Q000008:administration & dosage / Q000009:adverse effects*; D003128:Coma / Q000139:chemically induced*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D015878:Mydriasis / Q000139:chemically induced*; D012151:Resuscitation; D012601:Scopolamine / Q000008:administration & dosage / Q000009:adverse effects*
D018680:Cholinergic Antagonists; D012601:Scopolamine