[A case of central anticholinergic syndrome in pediatric anesthesia]

The central cholinergic syndrome developed in a 5 1/2-year-old child after premedication with midazolam and a short volatile anesthetic. Diagnosis was made more difficult because of a history of nephrotic syndrome, convulsions, relative acetylcholinesterase deficiency and chronic medication with a corticosteroid. Successful management of such cases depends on a through differential diagnosis before the institution of physostigmine therapy. Intensive postoperative monitoring is strongly recommended.