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PCP intoxication in seven young children
Insights
Phencyclidine (PCP) intoxication in young children presents with neurological symptoms like unresponsiveness and ataxia, differing from adult presentations. Early urine toxicology screening is crucial for diagnosis in pediatric emergencies.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Toxicology
Background:
- Phencyclidine (PCP) is a dissociative anesthetic with known psychoactive effects.
- Intoxication in pediatric populations is less documented than in adults.
Observation:
- Five infants and two young children presented with PCP intoxication.
- Neurological signs predominated, including diminished responsiveness, ataxia, nystagmus, and constricted pupils.
- Behavioral symptoms like aggression, common in adults, were notably absent.
Findings:
- Pediatric PCP intoxication manifests primarily as neurological deficits rather than behavioral changes.
- Parental denial of drug exposure was common.
- PCP urine toxicology screening is recommended for pediatric emergencies with unexplained neurological symptoms.
Implications:
- Highlights the need for increased awareness of PCP intoxication in infants and young children.
- Suggests specific clinical presentations warranting toxicology screening for PCP.
- Informs diagnostic approaches in pediatric emergency settings for undiagnosed unresponsiveness or neurological abnormalities.
Abstract:
Five infants and two young children were treated at a large children's hospital for phencyclidine intoxication. The clinical symptoms and signs were mostly neurologic, including diminished response to tactile and verbal stimuli (100%), ataxia (71%), nystagmus (57%), constricted pupils (57%), depressed sensorium, and stupor associated with a blank, expressionless stare (57%). Notably absent were the behavioral aberrations such as aggression, which are usually seen with PCP intoxication in older children and adults. The possibility of drug intoxication was denied by most of the parents or surrogate parents accompanying these small children and infants for treatment. It is suggested that a systematic investigation for possible PCP exposure, including a urine toxicology screen for PCP (preferably by immunoassay methods), be conducted whenever an infant or child is brought for emergency treatment of unresponsiveness, bizarre behavior, dyskinesis, dystonic posturing, atypical oculomotor and pupil findings, or evidence of hallucinations.