Department of Emergency Medicine, University of California, San Francisco, 1001 Potrero Avenue, Room 1E21, San Francisco, California, 94110, USA.
Muscle Nerve. 2013 Nov;48(5):823-7. doi: 10.1002/mus.23916. Epub 2013 Aug 30.
A 28-year-old man presented with acute flaccid paralysis and respiratory failure that persisted for 2 weeks after suicidal ingestion of unknown substances.
Extensive clinical, nerve, laboratory, and neuroimaging testing excluded alternative causes of this neuromuscular syndrome. Prompted by clues provided by family members, liquid chromatography time-of-flight mass spectrometry was used to investigate for the presence of poison hemlock.
Testing of the residue in a jar used for the ingestion of a poisonous concoction confirmed the presence of the nicotinic alkaloid coniine. Analysis of patient serum suggested the presence of conhydrine. Concentrations of amitriptyline and diazepam were also found to be supratherapeutic, but only through the first few days of hospitalization.
Herein we describe a case of reversible coma, flaccid quadriparesis, and neuromuscular respiratory failure caused by intentional ingestion of poison hemlock.
一名 28 岁男性因自杀摄入不明物质后出现急性弛缓性瘫痪和呼吸衰竭，持续了 2 周。
广泛的临床、神经、实验室和神经影像学检查排除了这种神经肌肉综合征的其他原因。由于家属提供的线索，我们使用液相色谱飞行时间质谱法来调查是否存在毒芹。
对用于摄入有毒混合物的罐子中的残留物进行测试，确认存在烟碱类生物碱毒芹碱。对患者血清的分析表明存在水芹碱。还发现阿米替林和地西泮的浓度高于治疗范围，但仅在住院的头几天。
本文描述了一例由毒芹故意摄入引起的可逆性昏迷、弛缓性四肢瘫痪和神经肌肉呼吸衰竭。
