Jellema K, Groeneveld G J, van Gijn J
Universitair Medisch Centrum Utrecht, afd. Neurologie, Utrecht.
Ned Tijdschr Geneeskd. 2002 Nov 16;146(46):2173-6.
A 52-year-old woman was in a confused state and had difficulty walking and swallowing, as well as dysarthria. That same day she had consumed some berries, which she thought were bilberries, but she had instead eaten Atropa belladonna (deadly nightshade). She made a spontaneous and full recovery within a few days. A 3-year-old boy, with amblyopia, was vomiting, had difficulty walking and had a temperature of 39 degrees C. He was agitated and had a warm, red skin and dilated pupils that did not respond to light. A suspected intoxication with a parasympathicolytic agent was confirmed upon an empty bottle of atropine eye drops being found at his home. The boy made a full recovery following treatment with physostigmine. It is important to consider an anticholinergenic intoxication in the case of patients who are confused, have difficulty speaking, large fixed pupils and fever. A specific anamnesis with respect to medicines, eye drops and berries or plants consumed can confirm the diagnosis. It is important to recognise an anticholinergic intoxication because without treatment, the outcome can be fatal.
一名52岁女性处于意识模糊状态，行走、吞咽困难，并有构音障碍。同一天，她食用了一些浆果，她原以为是欧洲越橘，但实际上吃的是颠茄（致命茄属植物）。几天后她自发完全康复。一名3岁男孩，患有弱视，出现呕吐、行走困难，体温39摄氏度。他烦躁不安，皮肤温暖、发红，瞳孔散大且对光无反应。在家中发现一瓶空的阿托品眼药水后，证实其疑似因抗副交感神经药中毒。该男孩经毒扁豆碱治疗后完全康复。对于意识模糊、言语困难、瞳孔散大固定且发热的患者，考虑抗胆碱能中毒很重要。关于所服用的药物、眼药水以及食用的浆果或植物的详细病史可确诊。认识到抗胆碱能中毒很重要，因为未经治疗，后果可能是致命的。
