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Case Report: Multiple Seizures After a Diphenoxylate-Atropine Overdose in a Small Child
Chun-Hui Wang1, Li-Jia Song1, Yang Yang1
1Department of Pediatrics, Tangdu Hospital, Air Force Medical University, Xi'an, China.
Insights
Accidental diphenoxylate-atropine overdose in children can cause severe toxic encephalopathy and diffuse brain damage. Prompt hospital admission is crucial for managing pediatric poisoning emergencies.
Area of Science:
- Pediatrics
- Toxicology
- Public Health
Background:
- Poisoning is a significant global public health issue and a leading cause of accidental injury in children.
- Oral drug poisoning in pediatric populations represents a critical emergency, frequently occurring via the digestive tract.
Observation:
- A case report details the diagnosis and treatment of a child experiencing diphenoxylate-atropine poisoning.
- The child presented with acute toxic encephalopathy, including coma, convulsions, and respiratory depression.
Findings:
- Brain Magnetic Resonance Imaging (MRI) revealed extensive bilateral damage to the caudate nucleus, lenticular nucleus, parietal lobe, precuneus lobe, and occipital lobe.
- Large doses of diphenoxylate can precipitate severe clinical symptoms and widespread cerebral injury in pediatric patients.
Implications:
- This case underscores the severe neurotoxic potential of diphenoxylate-atropine overdose in children.
- Highlights the importance of immediate emergency medical intervention for suspected pediatric poisoning to mitigate potentially irreversible neurological damage.
Abstract:
Poisoning is a type of accidental injury and it is considered a major public health problem worldwide. Oral drug poisoning in children is an important cause of accidental injury and even death. It is a common critical emergency in the field of pediatrics. Once a child unintentionally takes an overdose, regardless of whether it caused poisoning or not, they should be admitted to the hospital for emergency treatment. Acute poisoning in children most frequently occurs through the digestive tract. Drug poisoning can happen in children of all ages. In children younger than 1 year, drug poisoning is mostly caused by the parents during feeding, while in children aged 1-3 years, it predominantly occurs as a result of an accident. A case of diagnosis and treatment of a child with diphenoxylate-atropine poisoning is reported herein. The early manifestation of this child was acute toxic encephalopathy with clinical manifestations of a coma, convulsions, and respiratory depression. A brain MRI showed extensive damage to the bilateral caudate nucleus, lenticular nucleus, parietal lobe, precuneus lobe, and occipital lobe. Accidental administration of a large dose of diphenoxylate results in severe clinical symptoms and can cause obvious diffuse brain damage.
