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Kristoffer Schmidt Laursen Nørgaard1, Dorte Fris Palmqvist2,3

  • 1Operation og Intensiv, Regionshospitalet Randers.

Ugeskrift for Laeger
|November 3, 2023
PubMed
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Betel nut consumption can cause severe cholinergic effects, leading to unconsciousness and vision problems, even after resuscitation. This case highlights the risks of excessive betel nut intake combined with alcohol.

Area of Science:

  • Toxicology
  • Neuroscience
  • Pharmacology

Background:

  • Betel nut (Areca catechu) is widely consumed in Asia for its psychostimulant and cholinergic properties.
  • Intoxication reports are rare despite widespread use.
  • Combined use with alcohol may potentiate adverse effects.

Observation:

  • A 27-year-old male presented unconscious after consuming large amounts of betel nut and home-distilled alcohol.
  • Cardiopulmonary resuscitation (CPR) was administered.
  • The patient regained consciousness and subsequently experienced blurry vision.

Findings:

  • The patient's symptoms, including unconsciousness and blurry vision, were consistent with severe cholinergic toxicity.
  • Blurry vision was attributed to cholinergic-induced accommodation paresis.

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  • Full remission was achieved after medical intervention.

    • Implications:

    • This case underscores the potential for severe neurotoxic and ocular effects from excessive betel nut consumption.
    • Healthcare providers should consider betel nut toxicity in patients presenting with altered consciousness and cholinergic symptoms.
    • Public health awareness regarding the risks of betel nut and alcohol co-ingestion is crucial.