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[Strychnine poisoning].

N Scheffold1, B Heinz, H Albrecht

  • 1Medizinische Klinik I , Schwerpunkt Kardiologie. Norbert.Scheffold@Klinikum-Heilbronn.de

Deutsche Medizinische Wochenschrift (1946)
|October 16, 2004
PubMed
Summary

Strychnine poisoning causes severe convulsions. Aggressive management, including early intubation and muscle relaxants, is crucial for survival and preventing complications like kidney failure.

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Area of Science:

  • Toxicology
  • Emergency Medicine
  • Pharmacology

Background:

  • Strychnine poisoning is a medical emergency characterized by severe muscle spasms.
  • Rapid diagnosis and intervention are critical for patient outcomes.

Observation:

  • A 46-year-old male presented with generalized convulsions two hours after ingesting approximately 250 mg of strychnine.
  • Convulsions were triggered by external stimuli, with normal physical examination findings between episodes.

Findings:

  • Urine analysis using gas chromatography-mass spectrometry confirmed strychnine presence.
  • Diazepam was ineffective; intubation followed by a combination of midazolam, fentanyl, and pancuronium successfully controlled convulsions.
  • The patient was discharged from the intensive care unit on day three.

Implications:

  • Fatal outcomes in strychnine poisoning necessitate aggressive management strategies.
  • Early intubation, control of muscle tremors, and prevention of rhabdomyolysis and renal failure are vital.
  • This case highlights the importance of prompt and multimodal treatment for severe strychnine intoxication.

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