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VOLUME 16 , ISSUE 2 ( April, 2012 ) > List of Articles

CASE REPORT

A sound sleep

Alakendu Ghosh, Rudra Prosad Goswami, Swati Mondal, Subrata Basu, Partha Sarathi Karmakar

Keywords : Benzodiazepine, bilateral basal ganglia hyperintensity, India, MRI, poisoning

Citation Information : Ghosh A, Goswami RP, Mondal S, Basu S, Karmakar PS. A sound sleep. Indian J Crit Care Med 2012; 16 (2):106-108.

DOI: 10.4103/0972-5229.99128

License: CC BY-ND 3.0

Published Online: 01-03-2018

Copyright Statement:  Copyright © 2012; The Author(s).


Abstract

Benzodiazepine is a commonly encountered agent of poisoning, which is readily diagnosed by a pertinent history of drug ingestion and the clinical scenario. In the absence of a proper drug history, the diagnosis becomes challenging. Proper clinical assessment, urine assays and imaging play a very important role in reaching the diagnosis. We present a case of acute benzodiazepine poisoning without a history of drug intake. The key pointers toward diagnosis were an unarousable state with obstructive apnea. Magnetic resonance imaging (MRI) of the brain revealed peculiar symmetrical isolated globus pallidus T2 hyperintensity. We believe this to be the first report of isolated bilateral basal ganglia T2-weighted hyperintensity in MRI in the setting of acute benzodiazepine poisoning from India.

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  1. Mechanism of respiratory insufficiency in pure or mixed drug-induced coma involving benzodiazepines. J Toxicol Clin Toxicol 2002;40:35-47.
  2. Endozepine stupor: Recurring stupor linked to endozepine-4 accumulation. Brain 1998;121:127-33.
  3. Benzodiazepine poisoning: experience of 702 admissions to an intensive care unit during a 14-year period. J Intern Med 1989;226:117-22.
  4. Benzodiazepine poisoning. Clinical and pharmacological considerations and treatment. Drug Saf 1991;6:247-65.
  5. Isolated symmetrical bilateral basal ganglia T2 hyperintensity in carbon monoxide poisoning. Ann Indian Acad Neurol 2008;11:251-3.
  6. Magnetic resonance imaging findings in bilateral basal ganglia lesions. Ann Acad Med Singapore 2009;38:795-802.
  7. Persistent choreoathetosis in a fatal olanzapine overdose: drug kinetics, neuroimaging, and neuropathology. Am J Psychiatry 2005;162:28-33.
  8. Linear T2 hyperintensity along the medial margin of the globus pallidus in patients with Machado-Joseph disease and Parkinson disease, and in healthy subjects. AJNR Am J Neuroradiol 2007;28:1993-5.
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