Phencyclidine abuse mimicking head injury

Area of Science:

• Toxicology
• Neuroscience
• Emergency Medicine

Background:

• Phencyclidine hydrochloride (PCP) is a dissociative anesthetic with psychoactive properties.
• PCP intoxication can lead to a range of neurological and behavioral effects, varying with dosage.
• Atypical coma presentation can complicate diagnosis in emergency settings.

Observation:

• Two trauma patients presented with coma.
• Initial assessment suggested head injury, but neurological signs indicated a sensory blockade.
• Phencyclidine abuse was not immediately apparent in either case.

Findings:

• Both patients were under the influence of phencyclidine hydrochloride.
• The neurological presentation mimicked other conditions, delaying PCP identification.
• Delayed diagnosis of PCP intoxication can impact patient outcomes.

Implications:

• Clinicians should maintain a high index of suspicion for phencyclidine abuse in patients with unexplained coma.
• Considering PCP intoxication is crucial for appropriate and timely medical management.
• This case highlights the importance of toxicology screening in patients with altered mental status and trauma.