Toxic encephalopathy in a child induced by mistaken use of compound diphenoxylate hydrochloride in overdose
10.3760/cma.j.issn.1008-5734.2019.01.016
- VernacularTitle:误服超剂量复方地芬诺酯致幼儿中毒性脑病
- Author:
Zhengran FU
1
;
Xiaoling WANG
;
Guangbo BIAN
;
Fang FANG
Author Information
1. 国家儿童医学中心,首都医科大学附属北京儿童医院药学部,100045
- Publication Type:Journal Article
- Keywords:
Diphenoxylate;
Drug overdose;
Poisoning;
Brain injuries;
Epilepsy;
Pediatrics
- From:
Adverse Drug Reactions Journal
2019;21(1):67-68
- CountryChina
- Language:Chinese
-
Abstract:
A 2 years and 4 months old boy mistakenly took 10-20 tablets of compound diphenoxylate hydrochloride placed by his parents at the bedside. About 2 hours after taking the medicine by mistake,the boy developed lethargy and,about 3 hours after the medicine,he developed cyanosis of lips and lethargy accompanied by snoring. About 6 hours after the medicine,the boy was sent to the local hospital and treatments such as gastric lavage and oxygen inhalation were given. About 9 hours after the medicine,the boy was transferred to the General Hospital of Ningxia Medical University. After 7 days of symptomatic and supportive treatments,such as mechanical ventilation via tracheal intubation,naloxone rescue,fluid replacement,and diuresis,the consciousness of the child improved and he could breathe spontaneously. However,the boy still had high muscle tension of his limbs,exaggerated bilateral tendon reflexes,positive Babinski sign,positive ankle clonus,and intermittent paroxysmal postural abnormalities. The head Magnetic Resonance Imaging showed multiple abnormal signal foci in bilateral cerebellar hemisphere,parieto-occipital lobe,peri-lateral ventricle,anterior and posterior periventricular and corpus callosum. He was diagnosed as toxic encephalopathy and symptomatic epilepsy. One year later,it was known by telephone follow-up that the boy had severe mental retardation.
