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Symptoms of Central Anticholinergic Syndrome After Glycopyrrolate Administration in a 5-Year-Old Child

Linea Natalie Toksvang1, Ronni R Plovsing

  • 1From the *Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; †Department of Anaesthesiology, Køge Sygehus, Køge, Denmark; and ‡Department of Intensive Care, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

A & a Case Reports
|October 30, 2015
PubMed

Insights

Central anticholinergic syndrome (CAS) is rarely caused by glycopyrrolate. This case highlights a potential underdiagnosis of this anesthesia-related condition in pediatric intensive care units.

Area of Science:

  • Anesthesiology
  • Pediatric Critical Care

Background:

  • Central anticholinergic syndrome (CAS) is typically linked to atropine or scopolamine.
  • Glycopyrrolate is an uncommon etiological agent for CAS.

Observation:

  • A 5-year-old boy in the ICU developed agitation, apnea, hypertension, tachycardia, and anuria post-glycopyrrolate administration.
  • This presentation suggests a rare instance of glycopyrrolate-induced CAS.

Findings:

  • Glycopyrrolate can precipitate CAS, manifesting with significant autonomic and neurological symptoms.
  • The syndrome's presentation in this pediatric case underscores the need for vigilance.

Implications:

  • This case emphasizes that glycopyrrolate, though rare, can cause CAS.
  • It suggests potential underdiagnosis of iatrogenic CAS in operating theaters and ICUs.

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