Related Experiment Videos
[Carbamazepine poisoning in a small child]
Insights
Accidental carbamazepine (CBZ) intoxication in a toddler caused severe neurological symptoms, including seizures and unconsciousness. The child fully recovered within 36 hours after medical intervention, showing a similar pattern to diphenylhydantoin overdose.
Area of Science:
- Pediatric Toxicology
- Clinical Neurology
- Pharmacology
Background:
- Accidental drug intoxication is a significant concern in pediatric populations.
- Carbamazepine (CBZ) is an anticonvulsant medication with a narrow therapeutic index, increasing overdose risk.
- Understanding CBZ toxicity is crucial for prompt diagnosis and management in children.
Observation:
- A two-year-old female infant presented with unresponsiveness, tonic spasms of the left arm, and mastication muscles following accidental carbamazepine ingestion.
- Initial symptoms included unconsciousness and opisthotonus with a generalized tonic seizure post-gastric lavage.
- Neurological recovery was observed after 21 hours, with complete resolution by 36 hours.
Findings:
- Carbamazepine plasma levels were significantly elevated at 19.4 mcg/ml (82.06 micromol/l) 14 hours post-ingestion.
- The clinical presentation and recovery pattern were analogous to reported cases of diphenylhydantoin intoxication.
- The case highlights the potential for severe central nervous system effects from carbamazepine overdose in young children.
Implications:
- This case underscores the importance of vigilant monitoring for accidental medication ingestion in toddlers.
- Prompt medical intervention, including gastric lavage, can be effective in managing carbamazepine toxicity.
- Recognizing similarities between carbamazepine and diphenylhydantoin intoxication aids in clinical decision-making for anticonvulsant overdoses.
Abstract:
Accidental intoxication with carbamazepine in a non epileptic female infant of two years of age is described. On admission the girl was unconscious, reacting only to painful stimuli, with a tonic extension spasm of the left arm and a tonic spasm of the mastication muscles. After primary care and gastric lavage a general tonic seizure with opisthotonus occurred. CBZ-plasma level 14 hours after ingestion: 19.4 mcg/ml (82.06 micromol/l). After the girl recovered consciousness, 21 hours after ingestion, a period of restlessness was seen. 36 hours after ingestion the patient had recovered completely. Comparison with published cases is made, the analogy to diphenylhydantoin intoxication is pointed out.